This is what is meant by the phrase “pain is just an opinion.” The man landed on the nail, watched and likely felt the nail go through his boot, and then his subconscious brain took over. His brain analysed the situation, processed the fact that it had just witnessed a nail go “into his foot,” likely sensed the cold nail between his toes, and his brain came to the opinion that in order to protect his foot further, a pain response was required. This sort of reaction, although extreme, is actually not as uncommon as you think. Have you ever been walking along and bumped your leg or arm into something, and just shrugged it off as nothing serious. You then maybe catch a glance of it later on in the day, perhaps as you remove an item of clothes that was covering the area, and you notice there is a big cut or bruise covering the area. A few things might happen upon noticing this. You may just carry on doing whatever it was you were doing and just be surprised that there is now this big cut or bruise and wonder where you got it from, OR, it might suddenly start really hurting as you become acutely aware of the injured area.

Through research we now know that pain, 100% of the time, is created in the brain. We know there is no such thing as a pain receptor or a pain pathway, and we know that whilst there is sometimes a correlation between an injured body part and a pain response, we also know that just like the case of the 29 year old builder, we can have a pain response when there is no injured body part at all.

So what does this information mean for you as a person in pain, particularly for someone in chronic pain? The first thing that should hopefully give you comfort is that because ALL pain is created in the brain, if you’re experiencing pain, it is real 100% of the time. It does NOT mean you are just making it up, or “it’s all in your head” (I mean technically this is true, but it’s a very unhelpful comment to make). People who say “it’s all in your head” tend to be implying that your pain isn’t real and that you just need get on with it, which is the opposite of what you should be doing.

If you’re experiencing pain, it’s because your brain has come to the opinion that it needs to protect you from something. If you get told, “it’s all in your head,” and you must go about your day without having first tried to change your brains opinion on why you need protecting, then it can get stubborn and turn up the pain dial as it hasn’t been convinced that you don’t need protection. Whilst extremely frustrating, this is a very normal and healthy response, but also a response that shouldn’t just get ignored by being told to get on with it.

These same techniques can be used to trick the brain when it comes to pain. Another common technique is known as pacing. With pacing the aim is to take things slowly. Whatever you think you’re capable of doing, you do half of that, and then you monitor how you feel the next day, and even the day after. This is because there is something called pain latency. We don’t always experience pain immediately, often because the brain can be preoccupied in getting you through whatever it is you’re doing and then it decides to play catch up. Working out what is likely to cause you discomfort, and trying to organise your days around things that are highly stressful and easier on the body are really useful here. Some people use a traffic light system.