Pain. It’s the most common issue we hear in the clinic, and everyone’s experienced it at some point – whether it’s a stubbed toe, a banging headache, or a twisted knee. But what is pain, really? Is it simply a physical reaction to injury, or is there something more going on?
The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Wiech, 2016). The words “sensory” and “emotional” tell us that pain is more than just damage to our body; it’s heavily influenced by what we focus on, expect, remember, and feel. In fact, research confirms that these psychological and social factors play a huge role in how intense pain feels (Atlas & Wager, 2018).
Consider this example: imagine a man walking his dog in the Australian Outback. He feels a small prick on his leg, then looks down to see he’s been bitten by a snake. His body reacts with a rush of burning pain, just as he’d expected. He receives treatment, recovers, and gets back to his routine. Two years later, while hiking in a similar setting, he feels a prick in his leg again. He immediately recalls that painful memory and responds with the same intensity of pain – only to find out it’s nothing but a thorn.
So, what’s really happening here? Here’s how our mind shapes pain:
- Attention: Focusing too much on a painful area tends to make it feel worse. When we concentrate on pain, our brain gives it more significance, which increases perceived intensity (Sharpe et al., 2020; Wiech, 2016).
- Expectations: What we expect to feel can also make pain better or worse. Research has shown that expecting pain to be severe makes us experience it that way. On the flip side, positive expectations can actually lessen the pain we feel (Atlas & Wager, 2018).
- Past Experiences: Pain memories are powerful. When we experience pain, our brain stores it, priming us to react strongly in similar situations. This response may have evolutionary roots, helping us avoid harm, but it also means our past pain experiences can amplify new, less serious ones (Tracey & Mantyh, 2017).
- Emotional State: Emotions like anxiety and fear can trigger a more intense pain experience. Negative feelings amplify our pain responses, while more neutral or positive mindsets tend to reduce them (Thompson et al., 2018; Wiech, 2016).
Reference List
- Atlas, L.Y., & Wager, T.D. (2018). How expectations shape pain. Neuroscience Letters, 693, 24–31.
- Sharpe, L., Jones, E., Ashton-James, C., et al. (2020). Attention and pain: mechanisms and clinical implications. Journal of Pain, 21(3–4), 233–244.
- Thompson, K.A., Tran, B., & Geaghan-Breiner, C. (2018). Biopsychosocial factors influencing pain perception. Pain Medicine, 19(6), 1107–1115.
- Tracey, I., & Mantyh, P.W. (2017). The cerebral signature for pain perception and its modulation. Neuron, 55(3), 377–391.
- Wiech, K. (2016). Deconstructing the sensation of pain: The influence of cognitive and emotional factors. Nature Reviews Neuroscience, 17(2), 83–92.
