A construction worker fell on top of a nail, which pierced right through his shoe. The worker was in sheer agony and had to be given strong painkillers on the way to the hospital.

However, it was discovered in the Emergency Room that the nail had NOT penetrated his foot at all; it had gone through a gap between his toes!

This is not to say that the man’s pain was not real. He was most definitely in agony. However, he was not responding to a real event but an imaginary one. 

What essentially happened was this. His brain had constructed a story of the most likely scenario based on cues from the environment (seeing the nail go through the shoe) and decided that a pain signal was appropriate to protect the man from further harm.

Of course, this is a great anecdote not just to illustrate how complex pain can be; it also shines light on a very real problem that physicians encounter every day: How do you measure pain? 

To this day, when doctors want to measure or quantify pain, they rely on a startlingly simple question: Could you rate the intensity of your pain on a scale from 0 to 10, with 10 being the worst possible pain?

The issue with such a subjective scale is obvious. How one person perceives pain as a 9 may be just a 4 in another person. 

In fact, some of the illustrations of how we perceive pain differently are downright astonishing. 

In a Psychology Today article, Dr. Aditi Subramaniam observes the fact that while our levels of pain might be similar, people who are religious report feeling less pain than their atheist counterparts when shown a picture of the deity they believe (or do not believe) in. Or the fact that a negative mood not only increases pain but also reduces overall pain tolerance in patients with chronic conditions.

Dr. Subramaniam describes how she recently had a pinched nerve in her back (a condition called sciatica), and the path to recovery was slow and agonizing. There were days in the month (anyone who has ever menstruated knows what she means) when her pain tolerance was alarmingly low. “The same intensity of pain that she had been able to bear (somewhat) bravely in the days previously would easily bring me to tears.”

And how did pain affect her mood? Well, apart from losing patience with the two other members of her household more frequently than usual, she also noticed she was “taking a bleaker view of nearly everything in life.”

The neuroscience of pain

As with any other sensation, pain is processed in the brain. 

Dr. Subramaniam talks about touching something that causes pain. The pain signals travel from the hands to the spinal cord and then up to the brain, where they are processed, and the appropriate response is decided upon. 

However, when you touch a hot stove, why waste time involving the brain when a simple reflex arc can do the trick several times faster? Of course, the information about a potential injury and pain is eventually sent to the brain, and more complex decisions about the injury can be made.

The neuroscience of pain is complicated further by the fact that there isn’t one particular brain region or network for pain. There is also a considerable difference in the way different people’s brains seem to process pain. One person may crumble at the smallest sign of pain and others a much higher tolerance.

When pain is a signal for injury, of course, it’s can be lifesaving. But what happens when the pain ceases to be useful? Dr. Subramaniam’s experience with a pinched nerve that took several weeks to heal gave her a little taste of what it must feel like to be in chronic pain. 

Chronic pain can be a disease in itself. The pain outlasts any injury and even modifies the way in which the brain responds to stimuli such as touch. In some patients with chronic pain, a simple feather touch to the skin feels like intense burning.

Dr. Alan Fogel writes about a research study in Sweden discovering how body awareness training can reduce pain from irritable bowel syndrome (IBS). People with IBS experience daily abdominal pain and discomfort as well as disrupted bowel function. They may also have headaches, painful urination, fibromyalgia, panic disorder, anxiety, and depression.

Participants met with a trainer for two hours each week for a total of 24 weeks, learning to pay attention to felt sensations during daily movements. The body awareness treatment group, compared to a healthy control group, showed a significant reduction in IBS symptoms. In addition, participants reported greater self-confidence and an increase in their ability to cope. 

The bottom line is to learn—on our own or with professional guidance—to become comfortable with our discomfort. When our brain fights against the pain, it causes more pain and other distressing symptoms. 

It may sound counter-intuitive, but just allowing ourselves to feel our physical and emotional pain actually helps the nervous system to recognize and integrate those sensations. This has the effect of teaching us that pain is not a threat and also reducing the felt intensity of the pain. Accepting and feeling our pain is another way in which our brain and body can become restorative and healing.

Steven Campbell is the author of “Making Your Mind Magnificent.” His seminar “Taming Your Mind, Unleashing Your Life” is now available online at stevenrcampbell.teachable.com.  For more information, call Steven Campbell at 707-480-5007.

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