Everyone agrees that pain is a universal human experience.

We now know that pain is 100% of the time produced by the brain. This includes all pain - no matter how it feels – sharp, dull, strong or mild and no matter how long you’ve had it.

You might’ve had it for a few weeks or months- this is called acute pain and it’s common with tissue damage – say from a back injury or ankle sprain - and generally you’ll be encouraged to stay active and gradually get back to doing all your normal things-including work.

or you might’ve had it for three months or more and this pain is generally called persistent or chronic because in this type of pain - tissue damage is not the main issue.

What’s less clear though is when you’re told you have chronic pain”-is knowing what’s best to do about it? Well, in Australia chronic pain is a really big problem - in fact 1 in 5 people have it.

Having a brain that keeps on producing pain even after the body tissues are restored and out of danger is no fun. Some people say it still feels like they must have something wrong.

But that’s just it- once anything dangerous is ruled out - health professionals can explain that most things in the body are healed - as well as they can be - by 3-6months – so, ongoing pain being produced by the brain is less about structural changes in the body and more about the sensitivity of the nervous system- in other words, it’s more complex.

So, to try and figure out what’s going on - you need to retrain the brain and nervous system. To do this – it’s helpful to look at ALL THE THINGS that affect the nervous system and may be contributing to your individual pain experience.

What can help is to look at persistent pain from a broad perspective and by using a structured approach and a plan it’s less likely that anything important will be missed.

Let’s start with the medical side. Firstly - taking medication can help but only to a limited extent. It is the more active approaches that are necessary to retrain the brain. So using medications to get going is OK -and then mostly they can be tapered and ceased. Some people also think surgery might be the answer- but when it comes to a complex problem like chronic pain, surgery may not be helpful. So, if you’re thinking of surgery-it’s best to get a second opinion and remember to consider ALL the things.

Next, it is helpful to consider how your thoughts and emotions are affecting your nervous system. Pain really impacts on people’s lives and this can have a big affect on your mood and stress levels. All those thoughts and beliefs are brain impulses too- but you can learn ways to reduce stress and wind down the nervous system. This helps with emotional wellbeing and can reduce pain as well.

The third area to consider is the role of diet and lifestyle. Now it turns out that our modern lifestyle might not be so good for us- in fact what we eat and how we live may really be contributing to a sensitised nervous system. Looking at all the things like smoking, nutrition, alcohol and, activity levels - and seeing if there are any” issues “is a good beginning - and these things can go on your plan.

Then there’s often enormous value in exploring the deeper meaning of pain and the surrounding personal story. By stepping back and looking at all the things that were happening around the time the pain developed many people with pain can make useful links between a worrying period of life and a worsening pain picture. For many, recognising deeper emotions can be part of the healing process. [Illustrator - social situation/family dynamics/loss of job etc]

Last, but by no means least is physical activity and function. From the brain’s perspective getting moving at comfortable levels, without fear, and where the brain does not “protect by pain” is best- and you’ll gradually restore your bodies tissues.

So - to sum up pain. It comes from the brain and it can be retrained and when looked at from a “whole person or broad perspective gives you lots of opportunities to begin. So, get a helping hand if you need it. Set a goal and begin.


As one of Australia's leading multidisciplinary pain specialist clinics, we'll explain what chronic pain is and why it occurs. We'll also explain that chronic pain should be managed as a chronic illness and not just a symptom of an illness. We will provide you with coping tips and practical guidance to help you take the initial steps to get yourself on your road to recovery.