When it comes to understanding pain, we have a lot to learn. One area we’ll be focusing on is the immense role the mind plays in detecting and interpreting pain. This underscores the importance of pain management approaches based in mindfulness and psychological pain management strategies. 

Common pain myths and persistent beliefs 

We all know about pain, right? After all, we’ve all stubbed our toes, suffered from stomach aches, and perhaps even broken bones or had to recover from operations. From paper cut to pounding headache, pain is a companion many of us know well. How well though? 

Recent pain research contradicts or adds nuances and additional layers of understanding to much of what we thought we knew about pain, or at least helps remind us that pain is a complex, multifaceted phenomenon that continues to surprise us. 

To get started, let’s review a few persistent myths and beliefs about pain.

Myth #1: Pain is bad

Very few of us would claim to actually enjoy pain, and even then, we’d usually like some controls in place. Pain’s very unpleasantness is on purpose though, and pain is capable of triggering multiple systems and creating multiple sensations within the body. 

Why? 

1. To get our attention. We could compare sensation systems in the body to railways. Many sensations, including pleasure, take their time traveling through the mind and body, not unlike cargo trains. Pain, on the other hand, is a bullet train. Pain messages can use dedicated nerve pathways and can travel faster and more directly throughout the body, while pain signals in the mind are also fast-tracked. That’s because pain demands attention NOW.
2. To force a reaction. Pain is so fast and feels so demanding because pain signals accomplish one of the most urgent and important functions in the whole body: to protect us. If we were better at ignoring pain, we would hurt ourselves more often and more severely. That’s because a pain signal frequently forces a rapid behavior change. We often flinch, dodge, pull back, run, or fight back, all in the name of protecting valuable tissues that, once damaged, can take a long time to heal. Pain during recovery motivates us to get the rest we need and helps prevent re-injury. 
3. To help us learn. The unpleasantness of pain serves another function: to quickly ingrain long-lasting memories so we don’t risk that kind of pain and potential injury again, if at all possible. All of us who have once touched hot burners or car exhaust pipes don’t repeat it, for example! 

If it sounds like pain is functional, that’s because it is. Pain is nuanced and vital, serving many important purposes. In many ways, it’s an absolute advantage.

• Consider people born with congenital analgesia, the condition of being unable to feel pain. People with congenital analgesia don’t always know when they’ve broken bones. The first sign they may get of having burned themselves is the smell. Many people with this condition die before age three, and it’s uncommon to survive with it past 25, due largely to complications with injuries and infections. For them, a lack of pain is a serious challenge.

Myth #2: Pain always means damage

Pain can and often does indicate that your body is being damaged, as we saw above. 

Not all pain, however, happens because of a burn or other real-time injury. Specialists see this often in the case of chronic pain. One example occurs with chronic back pain, which is both extremely common throughout the general population and often resistant to treatment. At first clinicians believed the stubborn pain was happening because of spinal malformations they could see on X-rays and other imaging. A spinal disc slipping out of place can’t be good, after all, right?

However, some researchers imaged people without chronic back pain and saw the same kinds of slipped discs, bone spurs and other spinal malformations that were being blamed for patients’ chronic pain. Could it be possible that the malformations are not always linked to pain? 

As we age, it turns out, pretty much all of us display some sort of spinal malformation, many of which are painless and even sometimes self-correcting. That’s one reason spinal surgery can sometimes have such dismal success: it’s not always addressing an actual structural problem.  

Instead, this research helped experts understand that pain can be decoupled from physical damage. How is that possible?

It happens, to the best of our understanding, due to several factors:

• Pain signals that were once urgent and useful do not always dissipate correctly within the mind and body
• These retained signals (some researchers think of them as memories in the body) linger, telling the mind and body to keep guarding against threats that are no longer actively present, or urging the body to protect itself even after tissues have already functionally recovered
• With sustained vigilance and stress, mind-body systems that detect and process pain become hyperalert, often judging relatively benign sensations as threatening. This prompts the body to react as though it’s under attack, to keep pain memory pathways active, to stay stressed, and to “learn” to remain in pain. Over time, chronic pain occurs and can be very difficult to treat. 

Pain, then, can occur even when active, ongoing damage is not happening.

Myth #3: Pain is completely physical

Since we’re aware of feeling pain most frequently in our bodies, it makes sense we think of pain as physical. But pain is mental, too. In fact, to understand pain completely, it doesn’t actually make much sense to separate the mind and body, since the two work so seamlessly together while interpreting pain signals. For example:

• Pain analysis is very open to interpretation, since part of your mind’s job is determining how urgent any particular pain signal is, and thus how “big” to make the signal to get the most appropriate, protective response. (This is why it doesn’t always “hurt” that bad to get your finger pinched by a zipper, but can feel horrible to get an injection. From the perspective of your nerves, the sensations may be somewhat similar, but from the perspective of your mind, the injection may be much more potentially dangerous and therefore should feel much worse and demand a more dramatic response. This also explains why you can sometimes get stung by a hornet or scraped up after falling, but don’t immediately notice the damage...your nerves reported the raw sensation, but your mind may not have been paying enough attention to realize a hornet was involved, or was distracted during the fall, and so the sting or scrape didn’t feel as severe as usual.)
• People with comorbid conditions, like depression, typically feel higher levels of pain than non-depressed people when given an identical stimulus. Exhaustion, depression, anxiety, stress and other emotions can modulate how the body interprets pain. Happiness and other positive emotions do the same, but in the opposite direction, often buffering pain.
• Many neural pathways involved with mood control also handle pain processing. (Which is perhaps one reason why taking ibuprofen can sometimes improve mental pain and low moods, oddly enough.)

So are we claiming pain can be individualistic, contextual and complicated? You bet. That’s what the research so far shows. 

Fact: You can use your mind to help manage pain

It may sound wishy-washy that pain is so functional and yet so subjective. That’s one of its amazing facets, however. And since so much of pain processing happens in the mind and is so connected with the emotions, that means that much of pain processing and management is under your control. 

You can learn tactics, techniques and strategies to both cope with and manage pain, even persistent chronic pain. We can start right this minute with a brief exercise to help illustrate what we’ve been discussing.

Exercise: What has pain done for you?

Get a pen and paper or open a note or document on your electronic device. You’re about to make a list of everything pain has done for you. 

“What?! Are you nuts?!” you might be thinking. We don’t blame you. Pain isn’t pleasant, and if you’re a chronic pain sufferer, you might be bearing a grudge against it. 

However, we just covered how pain:

• Guards you
• Protects you
• Helps you learn
• Can be amazingly malleable
• Can work with (not always against) you

See if you can make that tangible for yourself by simply jotting down at least one example for every bullet point: 

• Pain guarded me when_________
• Pain protected me by___________
• Pain helped me learn___________
• Pain changed when_____________
• Pain helped me by______________

Do you see any reasons to be grateful or any aspects of pain to appreciate? Think about that for a while. Even write a short ‘thank you’ letter to pain if it seems it might help. 

Noticing and expressing gratitude, research shows, helps you make sense of what you’re feeling. Gratitude itself helps people feel happier, which helps temper pain sensations. This exercise won’t get you all the way to feeling pain-free, but it’s a step toward forming a less rocky relationship with your pain.