Gary 'Smiler' Turner's Blog

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Tuesday, 13 July 2010

What is Pain?

I’ve been working with several patients in respect to their ‘pain’ lately, including in conjunction with their consultants at their Pain Clinics. In this blog post I thought I’d explain what pain actually is, and how we experience it. (Everything here is put as a generalisation to enable simpler understanding.)

In later posts I’ll talk about pain control, management and regulation, together with the uses of hypnosis in the same. But first, what is pain?

Pain exists to keep us safe. It is a response to an alarm signal, our body’s way of saying ‘pay attention’. And this response helps us to avoid harm. Pain and withdrawal reflexes help us to keep ourselves safe. Pain makes us rest injured parts of the body which assists in recovery from any damage. It also reminds us to keep away from situations where in the past we had pain, or to pay attention to emotions that are not yet resolved.

Pain is a ‘somatic sensation’, in other words, it is a sensation felt in the body. But how is it created? Pain is a response to a signal. That signal could be from tissue damage, risk of tissue damage, learned behaviour, or unresolved emotions.

Pain as a result of tissue damage or risk of tissue damage is through a process called ‘nociception’. This starts with the nerve endings, or nociceptors, detecting the damage or risk, and sending this signal through our neurology to our brain. In the brain the signal is received, interpreted, and the synapses within our neurology fire accordingly and often produce the sensation of pain.

It is worth pointing out that the process of nociception is not in itself pain – it is just a signal that we can interpret as pain.

Pain can be as a result of learned behaviour. In the past we may have incurred injury and experienced pain, so if we are about to do that behaviour again, or are doing that behaviour we may experience pain, telling us not to do so. It is also well documented that current social norms also influence pain, and we can learn to feel pain as a result of other people’s behaviour, or even just hearing about it.

Unresolved emotions are also a source of pain, especially those with chronic pain. It has been documented that unless an injury is getting worse or being aggravated pain shouldn’t be felt six weeks after the injury – if it is, there is very likely an emotional element to that pain. Often repressed emotions become a source of pain – the pain being the signal that we need to pay attention and process that emotion through to resolution.

Pain is a cognitive process and it is due to this that our perception of pain can vary. Pain can come and go, may be intense, or just in the background, or we may just not feel it at all. And we can also experience pain whilst having no tissue damage or risk of damage to that tissue. We can control it by turning it off or on, or regulate or manage it to lessen or increase its intensity. And we can do all this because pain is created in the brain.

Now, whilst it is true that all pain is a perception in the brain, whether from tissue damage, threat of tissue damage, learned behaviour or unresolved emotions – all pain is most definitely real. And we all know how real that pain can be. So in future posts I’ll describe pain can be controlled, regulated and managed, so when we experience pain, we know how to pay attention to it.


  1. Good post Gary, excellent description of the processes that contribute to the uncomfortable 'chronic' pain that many people experience. Remember that the unconscious mind always looks for more of the same, when a somatic pain signal is received via the nociceptors, the area then becomes sensitive to pain. A good way to look at it is that your own brain becomes a magnifying glass which amplifies the pain signals received! This process creates what is refferred to as the chronic pain cycle and as you mentioned before is all abbout the mind, amazingly people avoid painkillers which can help to break the cycle (amongst other things which I am looking forward to hearing about).

    It is also important to note that pain is a muscle inhibitor, I thought I would highlight how that can affect the movement chain so important to how we function in easy tasks and indeed the hard ones!

    To put it another way; muscles do not work properly when a pain signal is present. Since the body will find a way of achieving the movements a person requires anyway (thats the way we are wired as human beings), a faulty movement pattern is often adopted. This results in muscles not supporting or moving the body the way they are supposed to, which in turn can lead to more pain! Since the majority of our movement patterns are learnt when we are children, out running around and doing activities innapropriate for the common adult the faulty movement patttern becomes the norm unless therapeutic intervention is applied.

    A friend of mine injured his knee and was partial weight bearing on crutches, he still stubbernly tried to walk around at the same speed he did before his injury. Since his body found a way to allow this locomotion he developed a limp. A year later and after his knee had injured, he still had his limp...He had learned to walk that way and was never corrected so that became his normal walk! An example of the impact pain can have on a person!


    Dave G


  2. Thanks for your informed comments as always Dave!

    Adds nicely to my post, and also highlights still further the need for an injury to be properly rehabilitated, and not just worked around.

    Best regards as always,