Understanding Pain: A Simple Guide for Clients
Written by Samantha Heyfron, Physiotherapist – Whittlesea Physiotherapy & Clinical Pilates
What is pAIN?
Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (IASP, 2020).
A few important points:
- All pain is real.
- All pain is created in the brain. This does not mean it is made up. It means the brain is the part of you that produces the pain experience.
- Pain is influenced by many things, not just what is happening in your tissues. –
For persistent pain, NICE guidelines recommend against relying on major pain medications as the main long-term solution.
Why do we have pain?
Pain is mainly about protection.
Think of pain like a smoke alarm:
- Your body sends signals (like smoke).
- Your brain and nervous system are the alarm system.
- Your brain decides if the alarm should go off.
Sometimes the alarm is accurate (real danger). Sometimes it is too sensitive (alarm goes off even when you are safe).
Acute pain vs persistent pain
Acute Pain
Acute pain is usually linked to tissue healing.
- Often sudden and sharp or intense
- Common after injury, surgery, or trauma
- Usually lasts from minutes up to 3 months
Persistent Pain
Persistent pain lasts 3+ months, even when tissues have healed.
- Can continue despite treatment
- Does not always have one clear “damage” cause
- Often involves an overprotective pain-alarm system
This is common, and it can improve.
Pain is influenced by more than injury
Pain is a dynamic experience. Your brain uses lots of information to decide how much protection you need.
Factors that can turn the pain alarm up include:
- Anxiety
- Fear
- Anticipation
- Beliefs about damage or harm
- Rumination (getting stuck thinking about pain)
- Past experiences
- Stress, poor sleep, low energy
- Feeling unsafe in your body
This is why two people can have the same scan findings, but very different pain.
Your brain predicts your experience (inside-out)
We often think pain works like this: Outside → In (something hurts in the body, so the brain feels pain)
But the brain also works like this: Inside → Out (the brain predicts what is happening and creates your experience)
Your brain is constantly making a “best guess” about what you are seeing, hearing, and feeling. It uses:
- Past experiences
- Expectations
- Beliefs
- The current situation (context)
If the brain predicts danger, it may produce pain to protect you, even when tissues are not in danger.
Neuroplastic pain (the brain can learn pain)
Our brains are neuroplastic, meaning they can change and rewire.
Neuroplastic pain is when:
- Safe nerve signals are mistaken as dangerous
- The brain produces pain as protection
A helpful phrase is: “Neurons that fire together, wire together.”
If the pain alarm has been ringing for a long time, the system can become quicker to ring again.
Key message: pain is a message from the brain
Pain is not simply a message from your body to your brain. It is better to think of pain as:
- A message from your brain to you
- A protective output based on the brain’s assessment of danger
Pain can be protecting you from many things, not just injury.
Why fear and expectation matter
With persistent pain, fearing or expecting pain can become a main driver.
If your brain expects pain, it may increase protection:
- more pain
- more tension
- more sensitivity
- more symptoms (like fatigue, dizziness, poor sleep)
This does not mean it is all in your head. It means your nervous system is doing its job, but it is overprotecting.
Good news: the pain system can be retrained
Retraining an overprotective pain system is often the key to reducing symptoms.
There are many ways to help the alarm system calm down, including:
- Education (understanding pain reduces threat)
- Gradual, guided movement and strength
- Better sleep and recovery habits
- Stress and nervous system regulation (breathing, mindfulness)
- Building confidence in your body
- Pacing (doing the right amount, not too much or too little)
As your clinicians, we can help you access tools within yourself to feel better and return to the things you value.
Watch and learn (video resources)
If you are feeling worried about pain, these are a great place to start.
1. Why things hurt:
https://youtu.be/gwd-wLdIHjs?is=A1Rp1JomFXts6sUl
2. Why does my back hurt?
https://youtu.be/lZlWq5TVvqg
3. Why hasn’t my pain gotten better?
https://youtu.be/2OF7Bybs84Q
4. Are painful movements and activities a sign I am doing damage?
https://youtu.be/MVqV9nXeczs
More helpful resources: – https://painhealth.com.au/
Whittlesea Physiotherapy & Clinical Pilates has been serving the Whittlesea community since 2005. Our experienced physiotherapy team provides evidence-based assessment and treatment for tendon conditions, sports injuries, and musculoskeletal pain across all ages and activity levels.
This blog is intended as general health information only. It does not replace individualised professional advice. Please consult a qualified physiotherapist for assessment and management of your specific condition.