Pain is An Output: How Misinterpretations Can Influence Pain

Pain is an output based on the brain’s interpretations of the information it receives and previous experiences. The pain you feel can be based on misinterpretations the brain has made. Even if the pain you feel is based on the brain’s misinterpretations, it is still real; it just has a different solution.

Pain is an Output

Many people don’t realize how involved the brain is with pain. There is often an assumption that pain means there’s damage, and ideally, that would be the case. The brain is involved in all pain. You won’t experience pain without the brain deciding it is warranted.

There are three main types of pain. You can experience only one or a combination of two or three when you have a combination that is often referred to as mixed pain. Mixed pain usually starts as nociceptive or neuropathic pain that gets sensitized with a nociplastic component. The brain and nervous system control all pain types.

Nociceptive Pain

In nociceptive pain, you have damage to the nociceptors in your skin and body. If the damage reaches a certain threshold, your body sends signals to the brain via the A and C fibres, and the brain interprets those signals. In the brain, When you have a paper cut, the pain you feel is due to signals sent to the brain by the damaged nociceptors in your skin, and the brain interprets that those signals show danger, threat, or harm. The brain then sends signals so you feel pain and protect the area of injury or that’s in harm’s way. Nociceptive pain is the pain system working as it was intended.

Neuropathic Pain

In neuropathic pain, the pain is caused by damaged nerves. The hardware that carries nerve signals is damaged, dysfunctional, or injured, which causes incorrect signals to be sent to the brain, resulting in pain. Neuropathic pain is due to a problem with the hardware of the pain system.

Nociplastic (Neuroplastic) Pain

When the pain system works properly, we stop doing things likely to damage our bodies. Unfortunately, when the pain system is not operating correctly, we can experience pain based on misinterpretations or extra sensitivity. Nociplastic pain is due to a problem with the pain system’s software. You feel pain despite nothing being structurally wrong with your body.

The Degree of Pain is Not a Good Indicator of Damage

The brain can misinterpret signals, and the nervous system can become sensitized, triggering pain faster and more intensely. There are many cases of serious damage and no pain and cases of severe pain and no damage. Your brain is limited in its perception due to the information it has.

Sometimes, people think that a bulging disc in their spine causes pain. Yet, a recent study found that imaging findings of spine degeneration are present in high proportions of asymptomatic individuals (people without pain) and increase with age. There are often findings on imaging tests that do not correspond with pain or other symptoms.

Using Optical Illusions to Understand How Our Brains Can Make Mistakes

Just as optical illusions can trick our brain, its interpretations of whether something is dangerous can be wrong. When wrong in a threatening or dangerous way, we often feel pain even if nothing is wrong or don’t feel any pain when something is seriously wrong.

Face and Vase

Just as this image can be interpreted as two faces or a vase, the signals from our bodies can be misinterpreted in multiple ways. Unfortunately, sometimes neutral signals in our bodies are interpreted as dangerous when they aren’t.

Previous experience can affect how your nervous system reacts to stimuli or other sensations. Suppose a sensation is similar to something dangerous that you’ve experienced before. In that case, your nervous system will have a different reaction than if you never experienced that sensation connected to a life-threatening danger. For example, if a sensation could be a stick or a venomous snake bite if you’ve been bitten, your nervous system will react with intense pain because of your previous experience with your life being threatened by a snake bite, even if it could only be a stick that poked you.

Past trauma or adverse childhood experiences (ACEs) can increase the likelihood that your brain will interpret neutral stimuli as dangerous because your nervous system has learned that the world is dangerous. The higher level of danger, threat, and harm you have experienced compared to care, compassion, and safety can influence your nervous system and cause it to have a stronger bias in interpreting threats in your body and environment.

Your nervous system will alert you according to the danger it feels you may be in. However, it can mistake a neutral object or sensation if it is similar to a dangerous object or if you have developed an association with that object that triggers fear or pain.

Missing Shapes

In the missing shapes optical illusion, our brains help us to see a triangle and sphere that isn’t there. Similarly, our brains can take sensations and different information to interpret what is happening. Unfortunately, sometimes it sets off an alarm, such as pain, in reaction to something it interprets as dangerous that is actually not dangerous.

Construction Worker Case Study

One famous example is a construction worker who landed on a 15cm nail that went through his boot. He experienced so much pain that he was sedated with fentanyl and midazolam before his boot was cut off, and it was found that the nail went between his toes. He experienced severe pain despite not being injured. His brain used all sensory data to come up with the perception that he was injured when he wasn’t. It saw that nail through his boot, knew that his foot was in the boot, and thought it needed to pull the alarm as there was a massive injury!

Placebo Suicide Case Study

In a published case study, a man was taken to the emergency room after attempting suicide with 29 capsules of an experimental drug he obtained from a clinical antidepressant trial. He was sluggish, shaking, sweating, and had rapid breathing. His blood pressure was extremely low at 80/40, and his pulse was 110. The emergency room doctors were not able to lower his pulse. What finally cured the patient was a doctor from the clinical trial letting the patient know he was in the control group and that he had overdosed on the placebo (sugar pills). Within 15 minutes, his vitals were back to normal.

When the brain receives corrective information, it can change its interpretation of what is happening and the danger level. In extreme cases, the symptoms can change quickly. In less extreme cases, you may have to put more effort into convincing your brain that its interpretation is wrong and create an environment that feels safe.

Bezold Effect

The Bezold Effect is an optical illusion that makes colours look different depending on their relation to adjacent colours. The red colour is the same throughout the illusion, but the brain makes the red lines next to the white lines look darker than the red lines next to the black lines.

The same thing happens with the brain’s perceptions around the signals it receives. When the brain receives signals in an environment with more potential danger, it is more likely to sound an alarm (pain) versus the signal being received in an environment with more safety. The brain uses more than just the signals it receives to decide whether a pain signal is warranted. We may be unable to change the signal (especially if it’s a neutral or safe sensation). Still, we can often change the environment around the signal. It may be within your body and mind or in your living environment.

Depth Illusion

Depth perception illusions make something appear different in scale than it actually is. In this image, the person looks as tall as a small tree when she is shorter. This is due to her being closer to the camera than the tree.

Pain can be similar in that the intensity of pain that the brain produces can be way more than the actual danger. This can happen in a number of ways:

1. You can become sensitized to pain at any point along the pain system. This means the nociceptors or spinal cord will trigger pain at lower levels than it normally would. So you may experience pain from a feather brushing your skin or stepping off a curb when you don’t have an injury that should be reacting to it.
2. Your nervous system can become efficient at producing pain signals. As you are in pain for an extended period, your body gains experience in producing pain signals. It, unfortunately, gets more efficient at producing pain signals, so it produces pain more easily and often more intensely than before.
3. The perceived danger in your body or environment can colour the brain’s perception of the intensity at which the alarm of pain is being sounded. This can cause your brain to trigger more intense pain than the signals would typically require.

Pain Based on Misinterpretation is Still Real

Your pain is real. Your pain is produced by the brain, just like the pain of someone with a visible injury. Pain is more complicated than a simple cause and effect. The mechanics may differ slightly, but you still feel and suffer from it. More things may trigger or influence your pain, which is more complex. What works for other types of pain may not work for you. All of this doesn’t mean that your pain isn’t real. It’s less understood. You didn’t cause your pain. Your pain happened due to a multitude of factors.

How Brain Retraining Can Help to Change the Pattern

Give Information that Your Brain Can Use to Correct the Misinterpretation

Brain retraining can involve communicating corrective information to your brain. Hence, your brain has the opportunity to re-evaluate its misinterpretation in the new light of information you’ve provided. This is why, in Pain Reprocessing Therapy an evidence list is built to use with Somatic Tracking. So you can retrain your brain to perceive the signals and sensations in your body more accurately. As your brain corrects the oversensitive reactions, your pain will reduce and may go away.

Creating an Environment of Less Danger to Lower the Bias Toward Pain

Perceived threats can cause pain, so creating an environment in your nervous system with an increased sense of safety and reduced threat level is essential. You can retrain your brain towards safety and away from threats with a multitude of skills from various therapies, including Pain Reprocessing Therapy, Cognitive Behaviour Therapy, Dialectical Behaviour Therapy, EMDR, Emotion Awareness and Expression Therapy, Somatic Experiencing, and Polyvagal Theory.

Conclusion

Pain is an output based on the brain’s interpretations of the information it receives and previous experiences. The pain you feel can be based on misinterpretations the brain has made. Even if the pain you feel is based on the brain’s misinterpretations, it is still real; it just has a different solution.