“It’s only in your head…” – a sentence that many patients with pain have already heard.

And this is where a big misunderstanding begins. Because pain is never “only physical” – and never “only psychological”. He is always both.

What is pain really?

Many people think of pain as a direct line:

Injury → signal → pain.

But it’s not quite that simple. Our body does register stimuli (e.g. heat, pressure or injuries) – this is called nociception.

But: pain first arises in the brain.

This means:

👉Two people can experience the same stimulus – and react to it completely differently.

Maybe you know that:

  • A small bump suddenly hurts extremely when you are stressed
  • You only notice an injury much later when doing sport

Why? Because your brain always has a say.

The role of emotions: More influence than you think

According to the definition, pain is not only a physical but also an emotional experience.

In concrete terms, this means:

  • Anxiety can increase pain
  • Stress can make pain last longer
  • Negative thoughts can make pain more intense

And vice versa:

  • Safety can reduce pain
  • Trust can promote healing
  • Positive experiences can change pain

👉 Pain and emotion influence each other – constantly.

Why chronic pain is so complex

If pain persists for a longer period of time, more than just the tissue often changes.

The nervous system becomes more sensitive.

Thoughts and expectations play a greater role.

Emotions such as frustration or fear are added to this.

You could say:

The pain “learns” over time.

And that is precisely why it is often not enough to just work “on the body”.

What does this mean for therapy?

Good therapy means today:

✔ Exercise and load build-up

✔ Understanding pain (education)

✔ Inclusion of thoughts & emotions

✔ Gradual return to confidence in your own body

Because: The body heals better when the system feels safe.

A personal thought from the field

Many patients are relieved when they understand:

👉 “My pain is real – even if you can’t see anything on the MRI.”

👉 “I can actively influence something.”

And that is precisely the most important step. Not away from the pain. But towards a better understanding of it.

Conclusion

Pain is not just a warning signal from the body.

It is a complex interplay of:

🧠 Brain
💭 Thoughts
❤️ Emotions
🏃‍♂️ Movement
🌍 Environment

The better we understand this, the better we can work on it.

💚If you need help with your training, rehab after injury, or just want to feel better and healthier in your body overall, feel free to contact us! Check out our offer or book a free online consultation.⠀

Source:

Gilam, G., Gross, J. J., Wager, T. D., Keefe, F. J., & Mackey, S. C. (2020). What Is the Relationship between Pain and Emotion? Bridging Constructs and Communities. Neuron, 107(1), 17-21.