Persistent pain: Is it all in your head?
What causes you to feel pain?
When you injure yourself, pain receptors at the end of your neurons (or nerves) pick up on this. These pain receptors send messages along the nerves to your spinal cord. From here, these messages run up your spinal cord to your brain, which interprets the messages as pain, which you feel. Pain has a survival advantage because it tells you that a part of your body has sustained injury and to pay attention to that area.
Persistent pain is generally defined as pain that has lasted for longer than 3 months (the time it usually takes tissues to heal) or after the physical injury has healed (i.e., there is no longer any damage to the tissues). In this case, your pain receptors may not actually be receiving much input from your tissues, but your spinal cord sends high-intensity messages to your brain, which translates them into a high level of pain. This is known as central sensitisation of pain. When this happens, you feel pain even if no damage shows up on your scans, and you can feel a lot of pain in response to very minor stimuli (such as being touched gently on your body).
Pain can also show up or worsen when you experience emotional distress. This can be explained by the shared neurobiology between pain and emotions. There is an emotional aspect of pain (the unpleasant nature of it) which is processed in the same areas of the brain that process our emotions (the anterior cingulate and prefrontal cortices). The experience of a distressing emotion, such as anxiety, also involves changes to muscle tension, which in turn can exacerbate pain.
So yes, pain is in your head. Specifically, your brain (and spinal cord). But this doesn’t mean that it’s not real, because the fact is you do feel pain, whether or not there is actual damage to tissues.
So what can you do about persistent pain?
It is important to get support from health professionals who have an understanding of how pain works and how to manage it. These can include:
Pain specialists
Physiotherapists
Psychologists
Occupational Therapists
Nurses
At Mind in Mind Psychology, we have psychologists who work with individuals experiencing persistent pain. Our training allows us to support you towards understanding your pain from a psychological perspective, and develop more adaptive ways of responding to thoughts, feelings, and sensations to reduce the overall impact of pain on your functioning. We also collaborate with other health professionals in your care team to provide evidence-based treatment.
If you’d like to include psychological support in your management of pain, feel free to get in touch with us by calling 0480 273 939 or sending an email to info@mindinmindpsychology.com.au. You can also visit our website to submit an enquiry: https://www.mindinmindpsychology.com.au/contact-us
Alternatively, you can contact our team by calling 0480 273 939 or sending an email to info@mindinmindpsychology.com.au.
Written by Dr Rui Ying Yew, Clinical Psychologist