No Brain, No Pain

Wellness Concept

No Brain, No Pain

From the Healing Bridge Physical Therapy

September 2008 Wellness Notes

By Nancy Hartung PTA


Is this pain from my body or my brain?

One of the most common questions from folks with chronic pain is “So, are you saying that my pain is all in my head?” As we are learning more about the physiology of pain, a simple, honest answer could be “Yes, all pain is produced in the brain. No brain, no pain.” However it is important to distinguish that all pain is real; the brain, spinal cord, and tissues work together to determine how much pain you experience. Ultimately the brain has the final say- kind of like the CEO.

As you continue to learn and understand pain, your knowledge will be greatly empowering for you and provide you with more solutions and strategies to control and manage the pain.

We have all heard amazing stories that describe seemingly impossible feats of survival of persons who have had serious injuries. In wartime battles, soldiers with serious traumatic injury describe having no pain or not noticing the injury until after the battle was over. There are reports of surfers who have had their legs bitten off by a shark, and at the time have reported only feeling a “bump or thump.” Many of us know the story of the amazing young man who was hiking and fell; trapped for days, he then amputated his own arm to release himself from the rock holding him. He subsequently walked to rescuers.

How is it that a paper cut can be immediately excruciating? Or a seemingly small injury can amplify to long term chronic pain? The seriousness of the injury is not necessarily related to the experience of an individual’s pain. Two people can have the same rotator cuff shoulder injury, but their experience of limitation from pain, may vary greatly.

Our neurosystem and brain have miraculous ability to adapt and modify in order to keep our bodies safe. It is all part of the instinctive survival mechanisms that drive our brains and our bodies. Danger sensors are scattered all over the body. The brain will activate several systems to get us out of danger. Once a message is processed in the brain, the brain concludes you are in danger and you need to take action; it then produces pain. If pain persists, the danger messages will continue and the response systems become more involved. The more involved they become the more danger messengers become excited, enhanced and become louder and louder. The brain starts activating more neurons and chemicals to gather and process the incoming messages of pain. The system becomes over efficient, overbearing, and overwhelming in the construction of the pain experience. Like a huge magnifying glass.

As you learn more about the pain experience you will find you can become less fearful, less anxiety ridden, and more hopeful about reducing or eliminating this pain experience.

Our brains also have a miraculous system in place to inhibit these over-excited, over-bearing danger/pain messengers and responses. We can access these brain abilities to reduce the pain through a variety of body systems. It takes some patience, persistence, and faith. Education and understanding on your part is critical in reducing the pain. Secondarily, engaging in activities and exercises to help the brain activate the pain inhibition process will be essential.

Here are some things you can begin to do:

1. Start walking if you can. Start at a baseline that does not increase your pain levels but will probably “nudge” it. For some this may only be 3-5 minutes. For others it may be 10-20 minutes. Do what works for you. But do not lose patience, hope or persistence. Do a little each day; on some days maybe you will only march in place a bit, this is okay, keep gently trying every day.

2. Use visualization to tell your brain that all is well in your body and your world. Give your brain a better story, a better picture. Imagine walking or sitting in your favorite place. It might be the mountains, the beach, your back yard with your spouse or pet. Make it sensory rich: imagine the smells in the air, the colors of the trees and flowers, the sounds of the birds, waves, breeze. Let yourself feel the parts of your body that aren’t in pain: how your hands are resting, your feet on the ground, how the air rushes into your lungs, expanding your ribs, and flows back out again. This is your visualization. You can practice this when you’re going to bed, waking up, or just resting during the day

3. Deep breathing/relaxation. There are countless techniques that you can access and use. Sometimes just counting each breath can change the brain’s focus (which likes to ramble on and on about most anything) away from the pain. If you are new to this, I recommend counting 1 as you breathe in, 2 with the exhale, 3 with the inhale, and so on up to 10. Then start at one again. Often, your mind will get busy and you will get distracted from your counting, no worries – just start over at #1 again. This can also be used as a meditation technique.

Have faith in your journey. You CAN reduce your pain experience. Understanding pain and implementing these strategies are your first step. Congratulations!