“It’s in your head” – how ALL pain is impacted by psychology

Over my 18 years as a physio and 5 years at Pure Physio, Albany one of the things many people are concerned about is that their friends think they have “pain in your head”.  In a very real way this is true of all pain, pain may feel in your leg but it is a pattern of responses that happen in your brain.

The obvious thing about that pattern is that it’s a sensation.  What’s less expected is many other bits of your brain are effected, emotion, awareness and amongst others part of the brain which produces pain killers

Pain, more than a feeling

I think most people would agree that pain can negatively affect their psychology making them angry, tired, low in energy, depressed or a mixture of all of these things but what about the other way around?

For a long time, it has been observed that people going through hard times whether because of life’s circumstances or because of mental illness report more pain than you might expect.  This has, in the past, been viewed as people in those situations being “whingers”.  Recent advances in science has shone a light on why this just is not the case.

It is generally accepted that this effect is least in people having a tough time psychologically (being made redundant, bereavement etc.), slightly more with common mental illness (mild depression, anxiety etc) and a much bigger problem in people with serious mental illness (more severe depression, bipolar disorder etc).  The area of our brain which produces natural painkillers is called the PAGM.  This allows us to ignore some trauma to our body and continue with essential tasks even after an injury.  Unfortunately, research has shown this painkiller producer can become much less active.  Possibly unsurprisingly the more mentally unwell a person is the less active it becomes, and as such the more pain they experience.  So people who are having a tough time psychologically actually experience more pain.

Lets get practical

On a practical level this means several things:

1. If you are in pain pay extra attention to things which help your mental health.
2. Don’t panic! The amount of pain you experience in the short term does not mean your pain will last longer or is less likely to be completely cured.
3. Show significant people in your life this article, possibly even your doctor. Their understanding of how your pain fluctuates can be helpful to them.