Is My Chronic Pain All in My Head?

Pain is an invisible illness. No one can see it, even if you’re in agony. It doesn’t show up on an X-ray or blood test. That’s led to many misconceptions about pain and its effect on your body and quality of life. One of the worst misconceptions is that you’re not really suffering; it’s all in your head. That’s simply not true. You can’t just “wish” pain away, but you may hesitate to bring up the topic because others don’t believe you — even some doctors.

At Interventional Pain Center in Legacy Office Park, Norman, Oklahoma, Dr. James Stephens and our team know that chronic pain is all too real and can severely impact your quality of life. That’s why we offer numerous pain management options to help you get relief. Here’s what you need to know about how chronic pain affects you.

What is chronic pain?

Chronic pain is pain that lasts for three months or more. It generally refers to pain that never goes away after an acute injury heals or after the period that should allow for healing.

Because the injury or tissue damage doesn’t heal as expected, the peripheral nerve fibers continue to fire off pain signals as if there’s damage that needs fixing. With unrelenting signals traveling from the injured nerves to the spinal column and then to the brain, eventually, the transmission pathways become more efficient at transmitting pain signals, and the net result is more pain.

While this is going on, the number of pain-causing neurotransmitters increases. Over time, the threshold for the pain receptors to fire drops, and, as a result, the nerve requires a less intense stimulus to send out a signal. What starts as a message from the injured site to the brain becomes a feedback loop within the nervous system and a disease of the brain.

Is my chronic pain all in my head?

As we’ve just seen, chronic pain results from a faulty nervous system, a very physical response. But because pain is a subjective experience and can’t be determined by an outside observer, it’s often labeled “psychosomatic,” meaning it’s psychologically driven or “all in your head.” This leads to stigmatization, which may prevent a person from seeking the medical attention they need for an undeniably real condition.

What is the purpose of pain?

Pain is a mechanism for identifying potentially harmful stimuli and withdrawing from them; it also helps protect injured body parts while they heal. However, chronic pain doesn’t serve these purposes, and it’s a leading cause of disability, affecting about 20% of people globally, and that number increases as populations age.

Traditionally, doctors have divided pain into two categories:

Nociceptive pain, triggered by acute injuries and inflammatory conditions and detected by pain receptors in our skin, bones, and other tissues
Neuropathic pain, triggered by damage to the nerves carrying sensory signals from the body to the brain and spinal cord

A few years ago, though, the International Association for the Study of Pain introduced a third category: nociplastic pain. This pain comes from altered processing of pain-related signals in the absence of actual or threatened damage. Such altered processing can lead to the amplification of the pain signal to no productive end.

Continued activation of the body’s pain pathways can also lead to brain and spinal cord changes. According to previous thinking, the body’s pain pathways were arranged in a fixed, solid, stable system. But now, researchers understand that these neural networks can be reorganized with persistent inputs, leading to an increased gain of the pain signal and thereby generating a heightened sense of pain.

With the increased gain, the brain and spinal cord nerves can become hyper-excitable, meaning that even a minor bump or scratch can become agonizingly painful, and even nonpainful stimuli such as brushing your hair can trigger pain. This condition is known as central sensitization.

Unfortunately, central sensitization can spread. Many patients with chronic pain develop generalized pain hypersensitivity, and if you quantitatively assess their pain system’s sensitivity, you find they have a lower pain threshold throughout their bodies, making chronic pain management a difficult task.

Central sensitization may also explain why so many people living with chronic pain conditions subsequently develop more of them, with more than 200 million people globally affected by chronic overlapping pain conditions.

If you’re struggling with any kind of chronic pain, Interventional Pain Center is the place you want to be to find relief. Call our office at 405-759-8407 to set up a consultation with Dr. Stephens, or use our online booking tool today.