The experience of pain varies greatly from one individual to another. It is influenced by multiple factors, including age, gender, environment, biological variables, emotional state, and stress. All these factors interact with each other to positively or negatively influence the experience of pain.

It is therefore crucial that individuals who are in pain take all these factors into account and understand them in order to manage their pain and heal. [1]

Our brain stores painful experiences

Throughout our lives, our experiences of pain are stored in our brain. It stores these past experiences in order to protect us from potential future pain. So if you fell while skiing on a bumpy slope and broke your arm, your brain will probably remember this, and the next time you come across a bump, you will most likely avoid it.

Added to this are the messages we constantly read and hear on social media, on television, etc., which reinforce negative beliefs about pain and promote pessimism and catastrophizing (a mental attitude that makes us expect the worst in any situation, which in turn increases our sensitivity to pain). [4, 5, 6]

“Don't carry that box while bending forward, you'll hurt your back!” “If you keep reading your text messages like that, you'll hurt your neck” and many other false beliefs that we have all heard at one time or another.

Our beliefs influence our behavior

Beliefs are numerous and all influence, to a greater or lesser extent, our experience of pain and how we behave in response to it.

We therefore see certain behaviors in some people, such as avoidance (remember the story about the bumpy track), kinesiophobia (the fear of movement; for example, I lock my back when I try to turn around, and I am then apprehensive about repeating the same movement for fear of triggering the pain again) or catastrophizing. Initially, these behaviors are useful for protection, but when they persist even though there is no longer any danger to the body, they become problematic.

Fear of pain and/or movement can then increase our sensitivity and amplify the pain signal, causing the alarm to go off sooner. We have then gone beyond the stage where pain was useful and protective.

Our beliefs influence our pain

The negative beliefs we have about our bodies and our pain therefore play an important role in behavioral and emotional responses and promote disability and handicap. When we have negative expectations and are convinced that the pain will get worse, we secrete more cholecystokinin, a substance that facilitates pain transmission. So the more negative thoughts we have about our pain, the faster and longer it will last. [2,3]

If we interpret pain as dangerous and associate it with negative thoughts, we will do everything we can to avoid it and avoid situations that we think are related to the trigger for that pain.

What do you think of this situation: “I hurt my knee the last time I took the stairs, so that's it, from now on I'm taking the elevator! Besides, I'm so tired that I might miss a step and fall!”

In this situation, the brain associates the stairs with knee pain and, worse still, with falling and the risk of serious injury. But if we think carefully about when the knee pain started: was it because I had been sitting at work for eight hours without moving and my colleague was bombarding me with messages to finish the file I was working on, so when I got home I wanted to rush up the stairs and hurt myself? Or was it because I hadn't slept for days, I was unmotivated at work, and I didn't even feel like exercising anymore, so when I got home exhausted, I wanted to take the stairs and the knee pain appeared?

In reality, it's not the stairs that are the problem, it's the association we've made with them that has caused our knee pain. So the solution is not to take the elevator every day to avoid pain, but to understand why, at that precise moment, I triggered the knee pain.

Conversely, if our thoughts about our pain are positive and we face our pain rather than suffer it, we are more likely to heal. [7, 8]

Did you know?

Studies show that avoidance and fear are predictors of poor recovery and chronicity in low back pain. It has also been shown that psychosocial factors related to catastrophizing pain are linked to the duration of absenteeism and disability in low back pain disorders. [7, 9, 10, 11, 12] In concrete terms, the more negative you are and the more afraid you are of your pain, the more discomfort you will experience and the longer you will be off work.

We have therefore seen that many factors can influence our experience of pain and that our beliefs and behaviors can exacerbate or, conversely, reduce it. Understanding these factors allows us to better understand our pain and thus limit false beliefs in order to adopt more appropriate behaviors when faced with pain.

Let's remember that:

➡️Pain is influenced by many factors: biological, physiological, and environmental

➡️The body and brain remember painful experiences

➡️Our beliefs, whether positive or negative, influence our experience of pain

➡️Understanding the factors that trigger pain allows us to change our behavior in response to pain

➡️Understanding our pain helps us feel better

SOURCES :

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350021/

[2]https://www.sciencedirect.com/science/article/abs/pii/S141335552030407X?via%3Dihub

[3]https://pubmed.ncbi.nlm.nih.gov/17873596/

[4]https://journals.lww.com/clinicalpain/Fulltext/2001/03000/Bias__Effects_in_Three_Common_Self_Report_Pain.8.aspx

[5] https://www.sciencedirect.com/science/article/abs/pii/S1521694209001570?via%3Dihub

[6] https://link.springer.com/article/10.1007%2Fs12529-016-9600-9

[7] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242994

[8]https://journals.lww.com/pain/Fulltext/2016/08000/The_fear_avoidance_model_of_pain.5.aspx

[9] https://linkinghub.elsevier.com/retrieve/pii/S1529-9430(13)01576-3

[10] https://www.em-consulte.com/article/877702

[11] https://www.sjweh.fi/show_abstract.php?abstract_id=1360

[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278039/

[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845348/

[14] https://www.sciencedirect.com/science/article/abs/pii/S1779012317304886