What Causes Pain?
How Your Emotions Matter More Than You Think
Pain can feel like a straightforward problem—fix the way you move, sit and stand, and fix the pain. I thought my own pain stemmed from poor posture, repetitive movements, and stress, all creating a structural issue that needed solving.
But pain isn't always that simple. Years into my struggle, a pain expert dropped a bombshell: focusing on biomechanics wasn’t the answer. Instead, he suggested, "Do what makes you feel safe and happy."
Wait—what? Should I abandon the Alexander Technique I had recently started, which left me feeling better after every session, to go pet puppies and hang out with friends? How could that possibly be the solution when it reduced chronic back pain by 86%¹ in a large trial I’d read about?
This moment forced me to confront the complexity of pain and its connection to emotional well-being.
What is Pain?
Pain often serves as the body's alarm system, signalling that something is wrong. However, its origins can be complex, involving not only the nervous system but also emotions and past trauma.
In chronic cases, pain may persist even after the initial injury has healed, revealing that pain is not merely a physical response but a perception shaped by the brain². When pain becomes chronic, it goes beyond the original cause, intertwining with emotional responses and altering the nervous system’s behaviour.
“Many people and health professionals act as if pain is produced in the body and detected by the brain, but this is inaccurate. Pain isn’t a direct measure of tissue damage. Understanding the true nature of pain is essential to help those in unnecessary pain and to gain a deeper understanding of how our brain and body function.”
Pain in this sense is a multifaceted experience that can manifest physically, psychologically, or emotionally—often without clear signs of tissue damage.
Reframing Pain: The Role of Pain Science
Understanding the brain's role in pain is essential. Imagine it as a faulty fire alarm—once triggered by something real, like a muscle strain, but now continuing to sound at the slightest movement.
Over time, chronic pain leads to both bodily ("bottom-up") and neural ("top-down") changes. Local inflammation may increase, and the peripheral nervous system might over-signal pain ("bottom-up"), while the brain and spinal cord may send fewer calming signals ("top-down"). This creates a cycle of pain compounded by negative emotions, stress, and neurochemical shifts.
But here's the hopeful part: your brain is capable of change. Thanks to neuroplasticity, you can retrain your nervous system and gradually turn down the intensity of those pain signals. It's not an overnight fix, but it’s a powerful reminder that your brain and body are adaptable, and you have more control than you might think.
Finding Relief Through Safety and Calm
I know it’s hard right now, and you're doing your best to find some relief. It’s okay to take this journey step by step. Understanding pain science is important, but it doesn’t all have to make sense immediately. Take your time with it. There are plenty of resources to support you along the way, which I’ve linked to at the bottom of this blog.
Effective pain management begins with fostering a sense of safety and reducing stress. What’s most important is starting where you are with what feels safe and soothing. Think of gentle movement, taking deep breaths, or finding moments of real rest. There are many other ways to get the body to relax the brain.
This might involve a warm bath or the gentle hum of a TENS machine. While these methods may not alter your physical tissues, especially if they've already healed, they provide comforting sensory inputs to the brain, reinforcing a sense of well-being.
Better sleep and healthy lifestyle choices also contribute to calming your brain and nervous system. Working on your psychology and emotions with self-help tools and professionals can too. These interventions, while seemingly distinct, share a common goal: reducing stress and promoting a sense of safety.
Complex Pain and the Need for Skilled Movement
For some, pain persists despite efforts to create safety and gradually reintroduce movement. Sitting too much, stress, demanding or repetitive work, movements like typing, and muscle tension can all contribute to pain that is challenging to alleviate. Here, the goal shifts from simply creating safety to cultivating skilled, confident movement.
A powerful approach to this is the use of touch and verbal guidance, as seen in practices like the Alexander Technique. In this method, touch is more than just providing reassurance - it becomes a tool for guiding the body into new movement patterns. By placing hands on specific areas, such as the neck or back, and offering cues to embody ease, practitioners calm the nervous system and realign the body.
This gentle guidance can relieve pressure on painful areas, reconnect parts of the body that have "shut down" due to pain, and reduce the instinct to brace against discomfort. Through expanding awareness and gently redirecting attention away from the pain - without ignoring it - this approach reduces the body's reactive tendencies.
You learn to move without fear, gradually breaking the cycle of anticipating pain or injury, and begin to move with calm, confidence, and coordination.
Conclusion
No one can say for sure whether your pain is purely driven by an overactive fire alarm in your brain or structural issues in your body. What matters most is breaking out of the habitual patterns that keep you stuck in a cycle of pain.
For complex pain that doesn’t respond to simple fixes, gentle, mindful movement systems like Alexander Technique, yoga, and tai chi are worth a try. These practices go beyond safety—they teach you to move with calm coordination, confidence, and skill.
Remember, your pain doesn’t define you - how you respond to it does. You have access to the tools to take control and reduce pain’s impact on your life.
Further Resources
Through my own pain journey I've explored many resources over the years. If you're interested in better understanding pain science and exploring holistic approaches here's some recommendations:
Pain Programs. Explore these programs for further support in managing pain:
REFERENCES
- Little, P., Lewith, G., Webley, F., Evans, M., Beattie, A., Middleton, K., . . . Sharp, D. (2008). Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. BMJ, 337, a884. doi:10.1136/bmj.a884
- Moseley, G. L. (2013). Reconceptualising pain according to modern pain science. Physical Therapy Reviews, 12(3), 169-178. doi:10.1179/108331907Ă—223010
