One of the key changes in the way that I think about my pain that resulted in great improvements in how I manage my pain is:
Chronic pain is my brain and body being really, really, really good at protecting me.
I was first introduced to this way of thinking about pain at the Pain Management Programme I attended in 2013.
I was never interested in knowing more about pain, or about my pain, before this programme.
I was certainly not interested in studying or researching pain! Why on earth would I want to learn more about something that was such a negative being in my life!?
Turns out understanding pain is a powerful tool in your pain management toolkit and that there are a lot of unanswered questions about pain. For my PhD, I tested if an impairment in attention might be one reason that pain makes it so difficult to think. That’s another story for another pinch or more another time.
Pain is produced when your brain detects threat to body tissue. One of the best explanations of pain I’ve seen is this talk by Lorimer Moseley.
In chronic pain, there is either ongoing damage to body tissue, or your threat protection system has become overactive and detects threat when there is none (1, 2, 3).
Many factors go in to the assessment of threat: including your previous experience (as with Lorimer and the pain he experienced from a scratch from a branch in the video), the context of the current situation, even your knowledge of pain (1, 2, 4).
Detection of threat is not under your conscious control, but one thing that is possible to change is how you think about and respond to the pain. I’m not saying this is easy. I’ve been practicing thinking that of my pain as my “overactive threat protection system” for years. It doesn’t always help me, and sometimes I still hate my pain.
The more I practice thinking about my pain this way though, the more I don’t feel overwhelmed by the pain.
- Moseley, G. L. (2007). Reconceptualising pain according to modern pain science. Physical Therapy Reviews, 12, 169–178. https://doi.org/10.1179/7108331907X223010
- Moseley, G. L. & Jones, L. (2009). Pain. In S. Kumar (Ed.), Ergonomics for Rehabilitation Professionals (pp. 71–102). Boca Raton: CRC Press.
- Tabor, A., Keogh, E., & Eccleston, C. (2017). Embodied pain – negotiating the boundaries of possible action. Pain, 158, 1007–1011. https://doi.org/10.1097/j.pain.0000000000000875
- Peters, M. L. (2015). Emotional and cognitive influences on pain experience. In D. P. Finn & Leonard, B. E. (Eds.). Pain in Psychiatric Disorders. Modern Trends in Pharmacopsychiatry (Vol. 30, pp. 138–152). Basel: Kager. https://doi.org/10.1159/000435938