Pain and language - how we talk can change how we feel

Chronic Conditions

How does pain work?

It might sound counterintuitive but pain is produced by the brain, not the body

How does it work exactly? 

We have danger detectors called nociceptors across almost all our body tissues that detect stimuli and send messages via the spinal cord to the brain. The nociceptors, spinal cord and brain are all part of our nervous system.

Our brain determines whether we need protecting and produces pain based on the messages from our body.

The thing is, our brain doesn’t just use information from our danger detectors to produce pain.

Our brains produce pain based on all sorts of information, including:

  • Information from our bodies via nociceptors
  • What we know and believe (including our cultural beliefs, expectations and previous exposure to the situation)
  • Information from our other sensors like what we can hear, see and smell

But what’s the point of all this pain? Well, pain is there to protect us. Pain tells us something is wrong, it makes us stop what we are doing and pay attention and helps to prevent worse injuries. 

Think about cutting yourself with a kitchen knife while preparing dinner. The pain you feel makes you stop, look at your finger and see the cut. By stopping you in your tracks, that pain you feel prevents you from chopping off the whole finger.

The nervous system and stress

Here’s where things get tricky. Stress makes pain worse and pain makes stress worse.

When we are under stress our nervous system is triggered. Our brain registers a threat in our environment and sets into motion the hormonal and physiological changes that help us fight or flee.

The problem is, our nervous system gets ready to fight or flee whether presented with a sabre tooth tiger, a work deadline or the stress that comes from managing chronic pain (and living a life!). 

A nervous system that is constantly triggered causes more pain.

How? Well being in fight or flight mode makes us tense. Our muscles become tight and with a constantly triggered nervous system they stay that way. We don’t move our bodies or breath optimally if we have chronically tight muscles which can lead to all sorts of issues. Not to mention how painful chronically tight muscles are in and of themselves.

And it’s not just about muscle tension. With persistent stress the nervous system is bombarded with messages telling us we are in danger. It’s constantly being triggered which leads to sensitivity to all sorts of stimuli.

Think about pain as an alarm in your body's security system (nervous system). Most people’s nervous system is wired for the alarm (pain) to go off when the security breach hits a certain threshold - for example a real threat like a person entering the house (or a broken bone). 

Most people with chronic pain have a heightened or sensitised nervous system.

The amount and severity of the pain they experience isn’t directly linked with the severity of dysfunction or damage in their body.

Their alarm (pain) goes off at a much lower threshold, say if a cat comes in the cat flap or a moth hits the window. And not only is their alarm (pain) triggered at a lower threshold, the sound is more amplified (pain is more intense).

Sometimes people with chronic pain are told they have a low pain tolerance. But that’s not quite right. It’s actually about how sensitive their nervous system is to information from their bodies and environment. The pain and the severity of the pain is real. And it’s not that they can’t handle pain (they’re handling a whole lot of it a whole lot of the time), it’s that their pain threshold is lowered just like the alarm threshold is lowered.

Calming the nervous system

If a heightened nervous system contributes to a more severe experience of pain, it follows that calming or down-regulating the nervous system reduces pain. 

There are a few ways to do that when it comes to chronic pain:

Address the underlying dysfunction - looking at the root cause issue should always be the first place to start when treating and managing pain.

Consider comorbidities - IBS, chronic fatigue, endometriosis, interstitial cystitis, pelvic myofascial pain, rheumatoid arthritis, autoimmune issues, anxiety, depression and PCOS are all common comorbidities with chronic pelvic health conditions can all trigger the nervous system and impact how much pain a person experiences.

Reduce inflammation - chronic pain and inflammation are part of a negative cycle. Inflammation can cause pain and chronic pain conditions can cause inflammation. And all that inflammation upregulates the nervous system. Looking at gut health and hormones is a great place to start when it comes to reducing inflammation. 

Reduce stress - through techniques like meditation, relaxation, gentle exercise, managing stress in the environment.

Reducing stress and pain through language

Calming the nervous system can be a tricky and involved process. What might work for one person doesn’t work for another.

And when you’re managing life with chronic pain making more appointments - even if it is to get a relaxation massage - can feel like the straw that broke the donkey’s back.

Adding one more thing to the to do list can feel like an enormous task. But there is something everyone can do, right now, for free to help reduce stress and calm their nervous system. And it’s all about language.

The language we use, the way we label and name threats, and the stories we tell ourselves, have a huge impact over how we process stress and fear.

Reframing our language can change a stressor from something we can’t control into something we can control. Which all helps to bring stress, fear and our nervous system response into check.

How does it work?

When it comes to the way we describe pain and stress to ourselves and others it’s best to stick to the facts. Factual language can help reduce fear, anxiety and stress. Which all helps to keep a well regulated nervous system.

Look at the difference between these two statements:

  • The house is a complete pigsty.
  • The dishes are sitting in the sink. The laundry basket is full. And the bathroom is dirty.

The first statement feels disastrous, uncontrollable and emotional. While the second statement sticks to the facts and takes out the emotive language. 

Both of these are stressful situations but the second statement enables an action plan while the first feels hopeless and tells our nervous system that we are under threat.

Here’s another example:

  • I am in so much pain. Everything hurts. I can’t do this.
  • Everything but my left hand and right eyeball hurts.

It might feel silly to acknowledge any tiny part of your body that isn’t in pain. But it does help. It’s factual and unemotional. It strips the statement of it’s hopelessness and power over our nervous system.

More info

If you’d like to read more about pain, stress and the nervous system we recommend:

-Pain Management Network

-Pain Australia

-Pain Revolution