Strange as it may seem, the way you think and feel about your pain plays a major role in how much pain you experience. This can be tricky to understand, as it occurs due to dynamic processes deep within your nervous system. To better comprehend this process, let us share a true story about one man's experience of pain.
This man, a 29-year-old construction worker in England, had an accident at work and was rushed to a hospital emergency room. He had jumped down onto a 15cm nail, which went right through his boot. Even the slightest movement caused him extreme pain—so much pain, in fact, that he had to be sedated. When the nail was finally pulled out and the man's boot was removed, something strange happened. It appeared that the nail had penetrated directly between his toes; the foot was entirely uninjured. Does this mean the man was faking his pain?
Not at all. This man's experience of pain was very real—no less real than if the nail had gone straight through his foot. But here's the catch; the pain was not caused by physical damage, but rather by his brain's perception of physical damage.
The man's brain perceived that he was seriously hurt, and therefore it created serious pain. The sight of a nail through his boot, the emotions—fear and frustration—that he felt, the thoughts he had about the situation, the environment (a hospital emergency room) he was in, and his social surroundings (fearful colleagues and doctors) all contributed to his pain. The man's brain received all this information and determined that the situation was unsafe. As a result, it fired up the pain alarm, and the man experienced severe pain. This may be an extreme example, but it perfectly illustrates how your environment, beliefs, expectations, and emotions feed into your pain. Put simply, they serve as a volume control for your pain.
This is not to say that your pain is all in your head. Whether caused by actual harm or perceived harm, your pain is no more or less real. Pain is your brain's opinion about your need for protection—but that doesn't mean these opinions are always correct.
When pain persists, the brain's perception of what is and isn't safe is altered. It generates pain in response to seemingly harmless stimuli—like physical activity, cold weather, or even strong emotions—all because your brain now perceives these things as 'dangerous'. Through understanding this, we can become more engaged in managing our pain and working towards recovery.