Understanding Pain

Pain is a fascinating, unpleasant, necessary and surprisingly healthy part of life. It’s such a complex and misunderstood phenomenon that it deserves detailed attention and appreciation.

Understanding the pain process and its purpose can be an enlightening experience and a powerful part of the healing process. There is much wisdom to be learned from pain.

We’ve been taught as a society to avoid pain, and really anything uncomfortable. While this seems obvious and logical, when objectively understanding what pain truly is and why we experience it, we realize this is simply a perspective, and not always the most healthy one.

Pain can be debilitating and take over one’s world. It can also be a teacher, a wake-up call, and guide to a better, healthier and more fulfilling life.

How we think about pain and also how we talk about and describe it is an extremely important part of the healing process. There is great power in words.

We often hear terms like "pain relief", "pain killer", etc. I think a better term is “resolve pain” or even “overcome pain”. I believe there is deeper purpose in resolving or overcoming as opposed to killing or simply relieving.

Killing and relieving is addressing the unpleasant symptom itself without regard for the actual cause or message the brain is trying to send via the symptom. It also indicates a passive approach in which the individual suffering is only reliant on something external to help.

Resolving or overcoming goes beyond the symptom and is more of an active process in which the individual who's suffering comes to terms with and deals with this pain signal and its cause(s). Of course there can be external influence to assist, but it is an active process in which the individual participates.

There can also be extreme circumstances of agonizing pain due to disease or severe trauma. This is not the kind of pain or situation I’m addressing here.

In this article, we’ll examine what pain actually is, the different types of pain, how to reframe our thinking about pain, and how to effectively address it.

What is Pain?

Pain is a healthy defense mechanism designed to keep us safe from danger or potential damage.

Pain is defined by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is a subjective experience, which can be influenced by psychological, social, and cultural factors in addition to the physiological processes that define it.

Think of it as a complex and multifaceted alarm system that alerts us to potential danger in order to prompt a response to prevent further damage.

Even though pain is a universal human experience, it is subjective. It’s uniquely perceived on an individual basis and can vary widely in intensity, duration, and in it’s impact on quality of life.

Everyone’s pain experience is different.

How Does Pain Occur? The Anatomy and Physiology of the Pain Process

The perception of pain begins with nociception, the neural process of encoding and dealing with noxious stimuli.

So what exactly is stimuli? Stimuli is the plural of stimulus, which according to Merriam-Webster Dictionary, is “something that rouses or incites to activity”.

A noxious stimuli is something that is causing, or can potentially cause damage to the body. The three types of noxious stimuli are mechanical, thermal and chemical.

An example of a mechanical noxious stimulus would be an impact injury or sports injury.

A thermal stimulus would be touching a hot pot.

A chemical stimulus example would be inflammation.

Nociceptors are specialized sensory nerve endings located throughout the body with the purpose of detecting these noxious stimuli. Once they’re activated, nociceptors send signals via peripheral nerves to the spinal cord and brain.

In the spinal cord, nociceptive signals are modulated by different neural mechanisms before being relayed to higher brain centers.

In some cases, a reflex response will cause muscles to involuntarily contract to avoid the source of the noxious, or potentially harmful stimulus without brain involvement. A classic example of this would be touching a hot stove and immediately pulling your hand away before the pain even consciously registers.

Signals are also sent to the brain for further interpretation.

In the brain, nociceptive signals are processed and then interpreted in different regions. Perception of intensity, unpleasantness, and emotional impact of pain are all based on the individual’s unique neurological connections within and between these different areas of the brain.

This processing of information results in an individual interpretation based on one’s history, genetics, learned patterns, emotional state, culture, etc. which then becomes the pain experience.

What are the Different Types of Pain?

The following three different categories of pain are determined by their cause. They are nociceptive, neuropathic, and neuroplastic pain.

• Nociceptive Pain: This is caused by damage or irritation to body tissue, or inflammation. It is the most common form and includes pain from cuts, bruises, injuries, repetitive strain, burns, degenerative arthritis, and inflammatory processes.

  
  

• Neuropathic Pain: This type of pain results from damage to nerves, often presenting as burning, tingling, electrical or shooting sensations. Common examples include sciatica, diabetic neuropathy, autoimmune conditions, and trigeminal neuralgia.

  
  

• Neuroplastic Pain: This is caused by misinterpretation of signals in the brain and not by tissue damage. It often starts with nociceptive or neuropathic pain that becomes conditioned and over time, even after the tissue is healed, signals that shouldn’t be interpreted as pain continue to be. This is heavily influenced by thought patterns, emotions, and stress.

What is Acute vs. Chronic Pain?

These terms describe how long the pain has been present.

Acute pain refers to short term pain that can come on suddenly due to injury or trauma. It can also be caused by inflammation and nerve issues. Nociceptive and neuropathic pain can both be acute.

Acute pain can range from mild to severe. Typically when pain is addressed appropriately in the acute phase, it will tend to resolve faster.

Chronic pain refers to pain that lasts more than three months or beyond the normal/expected time for the affected tissue to heal.

Chronic pain can be more difficult to deal with as other factors, such as mental stress and emotional state, in addition to the physical injury/insult to the tissues, come into play.

The transition of pain from an acute to a chronic state often involves complex changes in the nervous system. This is a process known as central sensitization.

During this process, the nervous system undergoes structural and functional changes that lower the threshold for pain perception and amplify the sensation of pain.

Basically, the nervous system becomes more sensitive and easier to irritate, causing pain to be more stubborn and persistent.

Multiple factors contribute to the driving and lengthening of chronic pain, including genetics, psychological stress, emotional state, culture, how we think about pain, ongoing tissue damage and irritation, and systemic inflammation. This is why the pain experience is unique to each individual.

Central sensitization can lead to a state where even non-noxious or non-harmful stimuli can provoke pain, which can complicate treatment and management strategies.

So in other words, even healthy signals sending information to the brain that should not indicate danger will be interpreted as potential danger and trigger the pain sensation.

Think of it as a faulty alarm system that is triggered when it does not need to be. Healthy movements, positions, even thoughts, can then bring about pain. This cycle then perpetuates itself as frustration, negative thoughts and emotional patterns become entangled in the neural pathways, creating a more challenging situation.

A common pattern with chronic pain is that people begin to identify with the pain, leading to states of hopelessness and self-pity. This mindset further embeds the faulty interpretation patterns and makes resolution more difficult. It becomes a vicious, self-perpetuating cycle.

This is why understanding what is happening from an objective point of view is a powerful tool. We learn to see the pain process for what it is, realize we can overcome it by reconditioning the neural pathways, and regain hope.

One of the most important things I believe patients must understand when dealing with pain, or any health issue for that matter, is that there is always hope and to keep moving forward.

Conclusion

Pain is far more than just an unpleasant symptom — it’s the body’s protective alarm system, shaped by biology, experience, and even emotion. It’s a complex and often misunderstood process.

By understanding how pain works, we can begin to shift perspective from fear and frustration toward empowerment. We can begin to see pain not only as a burden, but as a guide.

Remember, there is always hope!

In the next article, I’ll share practical, natural strategies for calming and regulating the nervous system, reframing the pain experience, and restoring healthy movement and function so you can take an active role in healing and in the resolution of pain.

Every person’s pain is unique, and so is the path to healing. If you’re in the Berkshires and ready to take the next step, contact us to schedule a personalized consultation.