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What's Your Brain Got to Do With Pain?

Pain can be a lot of things—stabbing, severe, unrelenting, sudden, aching, nagging…to name a few. We use many words to describe it, and we each talk about it differently.  

That’s because pain is a deeply personal experience, influenced by much more than just physical changes to your body. Your thoughts, emotions, relationships, experiences (including any prior pain or trauma) all play a big role in how you perceive and cope with pain. Understanding how pain works can help you take control of your symptoms and feel a whole lot better.  

Knowing the purpose of pain

Not all pain is bad. Pain is, at its initial level, a means to protect you. It is usually a warning sign that physical harm is coming and action is needed to stay safe. Like when you touch something hot—the pain you feel tells your body to move your hand before you get burned.  

Our bodies are smart, and pain helps us stay informed—most of the time.

When signals get mixed up

Sometimes our bodies get confused. We sense a threat and produce pain to protect us even when harm is not near.  

Take this well-known case of a construction worker: In 1995, the British Medical Journal documented the case of a man who accidentally jumped onto a wooden plank at the exact spot where a 7-inch nail was exposed (Fisher, 1995). The nail pierced straight through the bottom of the man’s boot, coming out the top side. In sheer agony, the man was rushed to the emergency room by his coworkers, where he was given opioids to make him more comfortable.

When doctors heard about the horrific accident, they examined the man’s foot and uncovered something even more shocking: The nail had not injured the man. It had traveled cleanly between his toes, leaving his skin, muscles, bones, and everything else untouched. Nothing was harmed.

So why was the man in so much pain?

Ultimately, his brain got confused. When the man stepped on the nail, his sensory systems—especially his visual system which took in the sight of a sharp object piercing through his boot, as well as the horrified expressions on his coworkers’ faces—reported to his brain that a terrible accident had occurred. The man’s thoughts and beliefs about trauma, as well as emotions like panic and fear, flooded his body with signals. His brain, trying to make sense of it all, produced pain to protect him.  

The pain this man experienced was real—but the physical damage to his body was not. This case teaches two very important lessons about pain:

  • Pain is rarely just about tissue injury.
  • Hurt does not always equal harm.

When your brain gets overloaded

This same kind of confusion can happen with chronic pain, when pain signals persist for a long period of time. Under constant stress, your brain can physically change. It can misfire and produce feelings of increased pain, even when there is no additional physical cause.  

Even the pain sensors in your tissues can change and become more sensitive with chronic pain. This means it can take a smaller stimulus (even just a light touch) to turn on these sensors and relay a pain signal to your brain. Sometimes these sensors can become so sensitive that they relay pain signals even when no stimulus is present.

The areas of the brain that can change with chronic pain also impact mood and behavior. This is in part why chronic pain can lead to other issues like depression, lack of focus, and increased anxiety.  

This graph shows how pain nerves can become more sensitive with chronic pain. In this heightened pain state (marked by the dotted red line), it can take a smaller signal (even just a light touch) to produce a pain response.

How pain impacts our lives

If you are experiencing muscle or joint pain, you are not alone. Muscle and joint conditions, such as back pain and arthritis, are the number one cause of disability across the world and the top causes of chronic pain. In the Unites States, about 1 in 5 adults live with chronic pain, and about 1 in 12 live with high impact chronic pain—meaning the pain is so disruptive that it blocks their ability to work and live life (Dahlhamer, 2018).

Out of this group, almost 90 percent have other medical problems such as depression, obesity, and sleep disorders that contribute to their pain (Von Korff, 2005).

Taking a whole-person approach

At Vori Health, we understand just how complex muscle and joint pain can be. That’s why we treat it from more than a physical angle.  

In addition to expert medical treatment, our care teams provide a full evaluation of other factors that might be causing or worsening your pain, including:

  • Your understanding of how pain works  
  • The amount of movement you get, as well as any fears you might have about moving  
  • Your thoughts about and reactions to pain
  • Areas of your life that might increase your pain or stress
  • Your sleep patterns
  • The amount of inflammatory foods in your diet

Looking at your pain from all sides, we help you get to the bottom of your discomfort. We help you uncover what might be causing you more pain, even when there is no physical reason for it. Together, we help you create new patterns that lessen pain, and we stay with you along the path to recovery.

Talk to our experts today to learn how our personalized approach can get you back to feeling like you again.


  • Dahlhamer, 2018: Dahlhamer J, Lucas J, et al. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults – United States, 2016. MMWR 2018 Sept 14;67(36):1001-1006.
  • Fisher, 1995: Fisher JP, Hassan DT, O'Connor N. (1995) Minerva. BMJ 310: 70.
  • Von Korff, 2005: Von Korff M, Crane P, et al. Chronic spinal pain and physical-mental comorbidity in the United States: results from the national comorbidity survey replication. Pain 2005;113(3):331-339.

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