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Why the amount of pain you experience doesn't just depend on the damage in your body

Consider for yourself. You're working on your favorite sport, getting totally into it. Suddenly you bump your knee. You hardly notice it, because you must and will continue. And you do go on, finish what you started and get a good result. After the time, you hardly notice that you had bumped your knee. 

Now imagine the following situation. You are at home and don't have much to do. You want to get something out of the refrigerator, and on the way you bump your knee. You curse the table you bumped into and find yourself in a lot of pain. You sit on the couch with a stretched leg, feeling sorry for yourself. 

How much pain do you have?

If we assume that in both cases the knee was hurt equally, you can imagine that the feeling of pain is quite different. If an interviewer in both cases had asked the question "How much pain are you experiencing now on a scale of 0 to 10?", it would probably have looked like this:

Situation 1: 'Yes sorry, I don't have time for that right now, it's not too bad. Huh... a 2, or so'

Situation 2: 'Pffff, ouch ouch. Yes I did hit my knee quite hard. Wait, I have to recover for a moment. This is an 8!'

It is a nice example of the 'subjectivity' of pain. Meaning, that the amount of pain depends only in part on the degree of damage to one's body. 

In fact, you could argue that the damage the body sustains doesn't even largely determine how much pain the brain creates! 


What's the difference?

By now we know about a lot of other things that affect the perception of pain much more than the actual "stimuli" that travel through your nervous system. 

Attention: the more attention you pay to the danger, the more room the brain has to produce pain. Just as in the example above, if the attention is somewhere else, a person quickly feels less pain. So when you're in pain, it helps tremendously to actively focus the attention somewhere else!

How you feel: Stress and other negative feelings make your pain system perceive danger faster and produce more pain. Also, tension can cause you to unconsciously (over)tighten your muscles, which can increase pain symptoms. It therefore helps especially to undertake positive or relaxed activities.

What goes on inside you: Beliefs about pain play an important role in the amount of pain experienced. Any thoughts that confirm "DANGER" increase the likelihood that your brain will create more pain. Especially thinking about the negative consequences produces a lot of harm. Also because it creates negative feelings. Reading about pain and how pain really works is a proven effective way in positively influencing thoughts about pain! 

What you do: Finally, "what you do when you are in pain" does matter the most. Especially if you manage to change your behavior so that your attention is no longer on the pain, you are having fun and have no room to dwell on negative thoughts. Often it works best, when things get tough, to occupy yourself with a hobby, or if you can, even a physical or social activity that gives you pleasure.

Same situation, different experience of pain

The same stimuli can, depending on how you deal with them, lead to very different pain experiences. This explains why people with the same physical problems never report the same pain. In fact, no researcher has ever succeeded in showing the connection between certain physical problems and pain! 

The beautiful thing is, there is enormous room for improvement in your own situation. Everyone can make progress with his or her pain symptoms, regardless of the underlying cause or diagnosis. Because we can all influence our attention, behavior, feelings and thoughts.

Why the amount of pain you experience doesn't just depend on the damage in your body

More guidance on how to decrease your pain