How Your Brain Can Make Your Pain Worse… or Better

By: Jonathan Ebersole, PT, DPT, OCS, Cert. DN

If you were walking down the sidewalk and sprained your ankle how would you respond? You would probably take a seat, rub your throbbing ankle, maybe say a few choice words, gather up your things after a few minutes, and limp home trying not to put pressure on your aching ankle.

What if you sprained your ankle while crossing a busy intersection and you look up to see a big shiny city bus is coming right at you. You would likely respond differently by running to the other side of the street without thinking twice about your ankle – it probably wouldn’t even hurt to run on it! If pain strictly came from the ligaments, muscles, and joints you would never be able to run out of the way of the speeding bus.

So, how does all this make sense? It turns out pain is actually a decision your brain makes based on perceived danger or threat. It is obviously more complicated than that, however, this is the simplest definition of pain. If you put your hand on a hot stove or stepped on a rusty nail, you would want to know about it. These are the kind of threats that the feeling of pain is meant to protect us from.

Do you think your beliefs or thoughts about your back, joints, or body can influence your pain and function? Before you answer that question, answer this question: Which line do you believe to be longer?

Despite what your brain may be telling you about what your eyes are seeing, the two lines are actually the same length. The brain makes the same decisions when interpreting the health of your tissues even if that information is wrong; negative beliefs about the body can be detrimental to overall health, activity, and pain.

If you view your body as a fragile entity that is just one false move away from injury or severe pain, you will change your behavior. You might even experience more pain because your brain is trying to protect the body based on your beliefs. Instead of continuing to exercise, walk, lift objects around your house, play with your grandchildren, dance, etc., you might spend more time resting, lying in bed, or trying to decrease the strain on the body. In the long run, this will make you weaker, have less endurance, stiffer, less flexible, and even decrease overall mood because the activities once enjoyed now hurt.

The truth is your pain is real! Even though pain is a decision made by the brain, it doesn’t mean your pain is made up, exaggerated, or all in your head. If your pain is chronic, it means your brain is most likely interpreting information incorrectly, like it did while looking at the two lines above.

So, what can you do about your pain?

• Physical Therapy is a great way to help slowly and methodically teach your body that it is okay to move, exercise, lift, etc. Tools like aquatic therapy, Alter G gravity-minimized treadmill training, and specific exercises can help improve function and gradually teach your body that movement and strain is okay and safe.
• Medical Psychology is a great way to have a professional help you work through the emotional barriers and daily stressors that may be playing a role in your pain.
• Aerobic Exercise can calm down overactive nerves that may contribute to pain. Twenty minutes or more of aerobic exercise helps release your body’s natural pain relieving chemicals which can help decrease pain.
• Eight hours of sleep or more are really important for healing and resting the brain and nervous system. If you are sleeping six or less hours each night, you are missing out on some important brain rejuvenation which may play an important role in pain.

Sheltering Arms therapists and psychologists can develop a customized plan for you to teach your body to relieve pain. To make an appointment to see how we can help your pain, click here or call (804) 764-1000.

References: (2018) “Therapeutic Neuroscience Education I: Teaching People about Pain.” International Spine and Pain Institute.