Pain... it doesn't always mean what you think...
- Lauren Cremona
- Jun 14
- 4 min read
Updated: Jul 16
Persistent pain is best understood not as a simple indicator of tissue damage, but as an experience shaped by interacting biological, psychological and social factors. Biologically, the nervous system can become more sensitive over time, so pain may persist even after an injury has healed or when scans show little to explain its intensity.
That does not make the pain "imaginary" - it means pain is produced by the brain when there is enough stimulus being sent to the brain (via our tissues, eyes, ears), in conjunction with our memories and the predictive ability of our brain, the brain concludes that we are in "danger". Be it real or perceived!
Think of pain like a house alarm that has become oversensitive. At first, the alarm goes off for a real break-in, which is helpful. But over time, it starts blaring at the postie knocking on the door to deliver a package or a gust of wind that slams the door shut too hard. In persistent pain, the nervous system can behave in a similar way: it is trying to protect you, but it has become too sensitive and starts responding to cues that are not actually dangerous. In other words, you've got more pain "bang" for your tissue "buck" (to quote modern pain research and neuroscientist Lorimer Moseley)!
The psychological part includes things like attention, fear, past experiences, mood, sleep and the meaning a person gives to pain. For example, pain often feels worse when someone is exhausted, anxious, or constantly bracing against it. It may ease when they feel safe, understood, and more in
control. The social part matters too: work stress, financial pressure, family responses, cultural beliefs, trauma, isolation and access to care can all amplify or buffer pain.
The nuance of the biopsychosocial lens is that it does not reduce pain to "it's all in your head". Instead, it recognizes persistent pain as real, complex, and influenced by the whole person and their environment, which is why effective care often combines physical rehabilitation, education, emotional support, and practical changes in daily life.
Understanding Pain helps you overcome pain
Research on pain science education (also called pain neuroscience education) has shown that helping people understand how pain works can improve outcomes, particularly for persistent or chronic pain. Pain science education explains that pain is influenced by interactions between the nervous system, thoughts, emotions, stress, expectations, and past experiences.
Studies indicate that this approach can reduce fear of movement, pain catastrophising, and feelings of helplessness, while increasing confidence to engage in daily activities and rehabilitation.
On its own, pain education may produce modest improvements in pain intensity, but evidence suggests it is most effective when combined with treatments such as exercise, physical therapy, and active self-management strategies.
A few ways it can help:
Reframes in your mind the relationship between pain and tissue damage - People often assume pain equals tissue damage or injury. That’s not always true, especially with persistent pain. Understanding that pain can become amplified or overprotective can reduce fear and catastrophizing.
It changes how the brain interprets signals - The nervous system can become more sensitive over time (“sensitisation”). Learning this helps people see flare-ups as meaningful information rather than automatic evidence of harm.
It increases confidence to move and function - When people understand that gradual, safe movement is more helpful than harmful, they’re often more willing to re-engage with activities they’ve been avoiding.
It supports practical self-management - Knowledge provides you with practical strategies to deal with your pain like pacing activity, improving sleep, stress regulation, exercise, rehabilitation and relaxation, rather than racing back to your GP for answers every time you experience a new episode.
It reduces helplessness - Chronic pain can feel unpredictable. Understanding patterns and triggers can create a stronger sense of agency: “I can influence this,” even if pain doesn’t disappear immediately.
How can movement help you overcome pain?
Movement can play an important role in overcoming pain by helping the body and nervous system rebuild confidence, strength and become tolerance to activity. When pain persists, people often reduce movement out of fear of causing further harm. But avoiding activity can lead to stiffness, weakness and increased sensitivity to pain. So not only will your body become less tolerant of everyday activities (like being able to get in and out of a lounge chair), you'll also experience disproportionate amounts of pain when doing those simple everyday tasks. Ultimately, this is likely to make you feel even more concerned, anxious, stressed and fearful. In turn, your pain dial gets cranked up a little further.
Research suggests that gradual, safe movement can help calm an overprotective nervous system, improve blood flow, restore physical function, and reduce fear associated with activity. Exercise and movement also support the release of natural pain-relieving chemicals and reinforce the understanding that movement is not always dangerous. Over time, consistent and paced activity can help people regain function, increase independence, and feel more in control of their pain.
Want to know a little more? Have a listen to this Tedtalk by persistent pain sufferer Lauren Cannell who learned how to overcome her pain.
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