The Truth About Pain

Sue Spence
Jun 8, 2023
6 min read

Updated: Mar 26

It's all in your head

How many times have you been told "It's all in your head!" Well, the truth is, it is all in your head!

We think the pain is coming from the source of the pain, be it a paper cut on a finger, the toe we just kicked into the table leg, or the knee we just scuffed on a tree. For those of you who suffer from any form of debilitating condition or mental illness such as major depressive disorder and have symptom flare-ups in the form of body aches and pains, or any other kind of pain-related condition, then this article will be of interest to you, as I give you the truth about pain and the control the brain has over it.

Hit by a Freight Train

I fell ill a couple of years ago and when I did it felt like I had been hit by a freight train at full speed. I am a migraine sufferer so I have a high pain threshold and generally none of the over-the-counter pain relief medication works for my migraines so I just sleep them off, but this was a whole different ball game. I woke up after a particularly nasty migraine, my worst one yet, to every single part of my body in agony. I ached so much that I lapsed back into sleep as I could hardly move I was so sore everywhere. My family were really concerned as they had never seen me like this before; I was like a zombie and the GP didn't know what was wrong with me either as all the tests were clear.

Mind Control

Before I continue with my story, which you can also read the whole story (Meet Sue Spence), let me explain how the brain and pain work so it makes sense. I'll keep it as simple as possible for us non-medical folk. Firstly the whole nervous system is controlled by the brain:

In the skin, and other parts of the body, we have nerve endings that can sense what is happening around us, i.e. heat, cold, sharp, smooth etc.;
These nerve endings pass the message along the nerve cells of the nervous system up to the brain;
The brain interprets these messages and sends a message of response back along the nerve cells of the nervous system to the nerve ending;
You now feel the response i.e. hot, cold, a prick, the smooth surface and you react accordingly by the brain also sending messages to the muscles in our bodies, well usually, by taking your hand away from the hot plate of the stove, putting a jacket on for the cold wind, removing the needle from your finger, and smiling as you stroke the cat's smooth fur.

You get the point, so now if you hurt yourself, it's the same thing when it comes to the pain:

The nerve ending has been damaged and sends a message that damage has been done;
The nerve cells of the nervous system carry the message to the brain;
The brain interprets these messages and sends a message of response back along the nerve cells of the nervous system to the nerve ending;
And you feel the pain of the injury.

The brain wants you to remember the injury

Now here is where the brain gets clever! It wants you to remember that you did damage to your body and that damage is not good, so it keeps sending the pain message while the injury is healing and sometimes for a while after to remind you of the injury. The brain doesn't want you to cause this injury again.

Phantom Freight Train

So now, getting back to my story and mental illness, how does my brain tell me I've hurt my actual brain by overworking and being overstressed from work? There is no visible wound or injury and my brain has already tried giving me headaches to slow me down, but I didn't listen and continued harming my brain by working long hours under stressful conditions in a stressful environment. Well, my brain did what it's programmed to do: it sent messages of pain to every part of my body to make it think it was injured, as if I had been hit by a freight train going at full speed, as if every bone was broken, as if every muscle was torn, as if my skin was cut to shreds, just so I would realise the seriousness of my situation. I have a very clever brain indeed! I did take note, but my brain still has the upper hand and reminds me when I overdo things; it's called symptom flare-up, and it's my brain watching me very carefully and telling me I have to pace myself. I haven't worked since November 2021 and am on disability now, but working on my recovery.

Sword of Damocles

So my brain is very clever, but I now have such a high pain threshold that it's a double-edged sword. I have missed serious medical issues because I don't realise there is a problem until its a huge problem as I am unable to distinguish the pain of the problem from the general aches and pains that have become normal life for me.

The specialists in hospital picked up an abnormality in my bloodwork which through a scan showed up a 1-and-a-half centimetre gallstone which I then had to have removed. I hadn't even felt the pain in my side as this was when I was still getting over the "freight train" injuries.
I damaged my left should rotator cuff not realising I had actually torn muscle and tendons and had to go for 3 months of physio to get the use of my left arm back again. The GP thought I already had "frozen" shoulder as I could hardly move my arm, but my physiotherapist worked her magic, and I did my exercises but I still battle as the symptom flare-up targets old injuries.
I had a really bad bladder infection which I did not realise until I was urinating blood and had to rush to the emergency room, at the GPs instruction, which resulted in a 5-day stay in hospital and a scope to check if there was any other cause for concern. Thankfully not, but I now have to be extra cautious as I've had this twice since, but now know what to do at least to avoid hospitalisation.

The point I'm making by sharing these stories is that it's really hard at times to know what is real and what isn't for me, as the person experiencing these things, so I can imagine how hard it is for my husband and family to support me. So for all of you out there supporting someone, I can imagine how frustrating it can be, as well as for those of you experiencing these sorts of medical issues. It can be a guessing game at times, and I do sometimes feel a tweak of pain somewhere and wonder if I should be concerned but don't want to cry wolf, but I also don't want to ignore something serious. Sorry, I don't have an answer on this one.

Pain Medication

While your injury is healing, you generally want to take medication to relieve the pain. No one wants to live with pain; it hurts and stops us doing what we want to do, so we take it. There are three main types of pain medication to take:

Anti-inflammatory medication works at the site of the injury by reducing the swelling and blocking the pain message being sent to the brain;
Paracetamol medication is thought to block the message in the spinal cord and brain (it appears not much is really known); and
Opioid medications, which are the strongest medications, decrease the way you feel pain and your reaction to pain and increase your tolerance for pain.

All forms of pain medication can become addictive and are not long-term solutions for debilitating conditions such as major depressive disorder as it's not solving the problem. This means an alternate pain management solution needs to be sought. In this area I am lucky, I've never been one to self-medicate and now, with my high pain threshold, I generally don't take pain medication unless I have a really bad symptom flare-up.

There can be bad side effects to pain medication, the most common being constipation which can lead to all sorts of complications. I had a bad case of this and it was also a hot day. I then went from constipation to diarrhoea, which then led to me being dehydrated and I collapsed and, again, it was a trip to the emergency room. Thankfully they topped me up with fluids and sent me home, but it was a horrible experience.

As you can see, I have had my fair share of both physical and phantom pain, and in a future article, I will share my experiences on how to manage pain better than by taking medication.

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