Learning about pain is now recognised as a key factor in one’s recovery.

 

If there is no need to become specialists in neuroscience to achieve healing from chronic pain or symptoms, it is useful to be aware of some basic facts.

 

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Firstly, pain is an experience created by our nervous system to protect us from harm.

Pain is not a direct measure of damage in our body.

 

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To simplify greatly what is such a complex process, let’s just remember that our nerves constantly send information to our brain about our internal and external environment, such as temperature, pressure, movement or chemicals.

 

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Our brain’s job is to decide whether any of that information represents a threat or not. And when it decides something is dangerous, it produces pain (or other symptoms) as a warning signal.

 

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What does this mean?

 

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• Pain is real (always!)

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• Pain is protective (not the ‘enemy’)

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• And the intensity of the pain does not always match what we see on scans or tests.

 

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Different ways pain can happen:

 

There are different biological reasons pain can occur:

 

• Injury-driven pain, also called nociceptive pain: pain from tissue damage or inflammation.

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• Nerve-injury pain, also called neuropathic pain: pain from damaged or irritated nerves.

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• Nociplastic pain: pain from a nervous system that has become overly sensitive.

 

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By the way, you could have more than one of these at the same time.

 

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Most chronic pain and symptoms are nociplastic- also called ‘neuroplastic’. What does this mean?

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Nociplastic pain can occur if your nervous system has learned to react too strongly.

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It often means that there is no ongoing injury that explains the pain, and the nerves themselves are not damaged. Instead, the brain and spinal cord are processing signals as more dangerous than they actually are.

 

A helpful way to think about it:

Your pain system’s sensitivity has been turned up too high.

 

 

And because of that:

• Normal movement can hurt.

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• Light pressure can feel painful.

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• Pain can spread or change location.

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• Symptoms can flare with stress, poor sleep or fatigue.

 

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This is a biological change in how your nervous system works, not something imagined or psychological.

 

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Why tests can look ‘normal’?

 

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In general, medical tests are good at finding broken structures, inflammation or nerve damage.

 

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They’re not good at showing nervous system sensitivity.

 

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So normal scans do not mean that ‘nothing is wrong’, or that ‘the pain isn’t real’!

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They mean the problem is in how pain is being processed, not in damaged tissue.

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And this is why there is so much confusion amongst chronic pain sufferers who have been told ‘there is nothing wrong with them’, or that whatever was found on tests should not ‘justify’ such intense symptoms. Unless the person diagnosing is aware of neuroplasticity, it could be the start of an unending cycle…