Pain Isn’t in Your Head: It is Your Head
Chronic pain has become a hot topic recently. As pain science evolves, more and more research is corroborating that chronic pain is not a problem with the body, it is a brain signaling problem which results in longterm physical symptoms. Sometimes the trigger for chronic pain is a tweak to an existing injury: other times the trigger is an emotionally traumatic event that overloads the nervous system. In either case, the brain can’t manage compounding uncomfortable sensations so the pain is expressed through the body.
Back pain is an all-too-familiar example of this. The pain can be extraordinary and the symptoms quite frightening--everything from searing pain, paresthesias, and foot drop. The experience is often unbearable and we go to the doctor hoping to be diagnosed with a problem that can be quickly fixed.
Unfortunately, this sort of back pain does not have a singular cause. Recent science has debunked the efficacy of the two most commonly given diagnoses—structural asymmetries and disc dysfunction. If the human population were all given MRI’s most adults would have these conditions, and most of us are not in searing pain. When a radiologist reports disc herniation, rarely are we told that our pain may not have anything to do with our imaging. Instead, the herniation becomes an explanation for our pain and surgery quickly seems like the only option even though there is minimal causation between scans and pain levels.
The question we should be asking is not WHY but WHY NOW? If we all have asymmetries and bulges, what is triggering an exaggerated response?
One viable hypothesis is termed “Boiled Frog Syndrome.” We go along in our lives without noticing degenerative changes until a force enters our body that is too quick, too strong, too long, or it happens too often. Our body enters a protective mode whether muscular or neurologic, sending pain signals to prevent us from the risk of future or further injury. Once this neural pathway is established, it becomes an unconscious habit. Anytime the body perceives threat, it reignites this pattern. The cranky SI, or the tweak to the QL or psoas spasm, is really the body calling on our structure for protection.
The susceptibility for some of us to experience chronic pain may also have to do with our ability to metabolize trauma. When our body is overloaded with stress, emotional trauma, or tissue trauma, we become more sensitive to stimuli that might be causing our body harm. Depending on who we are and our life circumstances, we may even become hypervigilant and thus our pain pathways overcompensate even when we are mildly challenged.
The critical takeaway is that the pain didn’t happen because of the routine movements of our lives. The pain happened because a novel stimulus triggered the brain to overreact. Sometimes that novel thing is lifting something too heavy or too quickly or too repetitively. But sometimes that novel thing is a life change, emotional insult, or re-triggering of old emotional baggage.
The recovery process isn’t easy not because it requires re-training-- but because it requires BRAIN RE-TRAINING. We need to find ways to re-introduce healthy movement and reinforce our sense of safety to decrease faulty pain signaling.
Here’s what I’ve learned so far:
When we’re struggling with pain, we need care. PERIOD. Pain takes a lot of energy and when we’re in it, we do need to reprioritize rest if we can, even if it doesn’t feel relaxing.
We need to have an internal practice. It doesn’t have to be formal meditation, but breath awareness, guided imagery, a warm bath, or journaling all function to give the psyche space to process what’s going on.
We need an external practice. We need to find the movement that can work in this painful period to restore our fitness and our agency.
We need to acknowledge our stressful triggers and work with them--especially with trusted practitioners. It’s not easy to go through these experiences relying solely on friends and family. Practitioners can add layers of expertise and support that make all the difference. Sessions that influence your sense of confidence and wellbeing are essential. It really doesn’t matter what the modality is as long as the person is your person.
The body, mind and spirit are all equally involved in recovery. It’s hard to make them all a priority but it’s necessary, especially the aspects that feel less explored.
Back Pain isn’t “All in your head.” It’s a real physical experience that has its roots in your nervous system. Learning how to retrain your brain is the first step to breaking the pain cycle. There is help and there are practitioners, myself included, who can support you on this deep but worthy path to recovery.