Pain – is it all in your head?

Isn’t it frustrating when you’re trying to get a health professional to understand your pain and they give you vague responses like; ‘it’s all in your head’ or ‘let’s try these tablets out’ or ‘I’m not sure, maybe you should see someone else’. Surely they should be able to give you a straight answer as to why you’re in pain and how to fix it, right?

The truth is pain is a weird and wonderful thing, that differs from person to person. If you want it to work properly for you, it helps to understand it a little.

With that in mind, let’s bring it back to basics and begin with a simple explanation of the science behind pain and its purpose. Well, as simple as it can be. For the sake of this article I won’t be digging deep into every nook and cranny of pain. Just touching on aspects of pain to guide you to a clearer view on what can influence and affect your pain.

Throughout our nervous systems are millions of sensors. These sit amongst individual nerve cells, known as neurons, allowing them to detect stimulus in the tissues and convey information. Once activated they’re sent to the spinal cord reaching the synapse, the “sorting room”, causing chemicals to release and activate these “danger messages”. If the level of activation becomes too high, the message is passed onto the brain. The brain then has the responsibly to ultimately decide how to feel, and react to the sensation. If pain is the conclusion the brain will active the necessary systems.

For example, touching a hot oven will be detected by the neurons in your finger, the message races through the spinal cord, into the synapse to the brain. You will quickly move your hand away and run your finger under cold water as the burning sensation is painful.

Persistent pain happens when your danger alarm system become sensitised. When you’re injured, your spinal cord and brain adapt to meet the high demand of processing all the danger messages. This makes the system more sensitive, allowing more messages in and the brain ends up being told there’s more danger than there actually is.

So why is it that every one of us have the same mechanisms to recognise pain and protect us from it but we all feel pain differently? It’s due to influential factors, including your thoughts and experiences.

Your thoughts are a result of chemicals released in the brain and nerve impulses. Negative and fearful thoughts can affect the brains’ survival instincts and increase the intensity of pain. Certain thought processes are powerful enough to maintain a pain state (3) and can even heighten pain. For example, when you’re dreading going to see your physiotherapist as they’ll be moving your once broken, now painful leg you’re more likely to tense up and panic. Letting your anxieties take over increases your adrenaline levels and the sensitivity of the alarm systems.

So, what is the best approach to handling and managing your pain? When you’re seeing any health professional, it is extremely important for you to feel empowered and in control – your pain, your problem! Ask questions when unsure and voice suggestions if you feel it may help. They should have the ability to work with you – they’re called a “professional” for a reason. Trust their help, but question if it feels necessary. Likewise, coping strategies are key, alongside being patient and persistent. So, attending your Pilates class once a week and catching up with friends are just as important as meeting with your doctor.

So when your doctor says “it’s all in your head”, don’t worry they aren’t implying it’s made up. Your pain is indeed produced by your brain to protect you and is real. Do not ignore your pain. Take it head on, understand it and see it in a manageable manner. There will be a solution that works for you!



(3)   Dr David S. Butler and Prof G. Lorimer Moseley (2013). Explain Pain. Australia: Noigroup Publications.