Pain and the brain

Pain is complicated. It is a result of much more than the initial disease or injury that set it off. In the past, people believed that pain signals traveled only one way – from a nerve injury up to the brain. Scientists have now learned that the brain has the ability to act like a “gate”, controlling the messages that are received and sent out from it. They call this the “Gate Control Theory” of pain. An important part of this theory is that scientists know that the brain can send messages that block painful sensations down to different parts of the body.

A good example of this is when an athlete has an injury in the middle of an important game and ignores, or doesn’t even recognize, the fact that a serious injury has occurred. It is only later, after the game is over, that they discover how painful the injury is. This helps to explain why some people experience less pain when they are distracted by other events going on during the day, but then notice their pain much more during the night when there is little activity around them.

There are physical, emotional, and mental factors that can “close the gate” and reduce pain. Physical factors include:

  • Medications
  • Surgery
  • Stimulation by heat, massage or acupuncture
  • Reduced muscle tension

Emotional factors that can “close the gate” include:

  • The individual’s optimistic feeling that things will get better
  • Social support from family, friends, co-workers and health care providers
  • A healthy mental attitude
  • A lowered level anxiety
  • Less feeling of depression

Mental factors that can “close the gate” include:

  • Distraction
  • Humor
  • Actively taking charge, rather than passively waiting to see what happens
  • Having feelings of control over the pain

Pain is a personal experience. The more that you can identify the specific factors that affect your pain, the better you will feel about your ability to manage it. By tracking your pain through the Daily Tracker offered on, you can get a better understanding of the pattern of your pain, and discover what factors increase or decrease your discomfort.

Even though your pain may be due to a physical event, like an accident or medical condition, over time, other factors come into play. These include your personality, your beliefs about what pain means, your outlook on the future, the world around you, the existence of a lot of support, or little support, from family and friends, your feelings of high stress or low stress. They all can affect how you perceive (experience the feeling) your pain.

Once people believed that pain was either physical (organic) or mental (psychological). Now, most people agree that pain is not the result of psychological factors alone. Since there is no way to objectively measure pain, by definition, “pain is what people say that it is”. Pain is both a physical and a mental experience.

Because chronic pain can influence every part of your life, individuals with pain may report problems with sleep, work, social functioning, and the ability to do daily activities. They may report being depressed, frustrated, anxious, and irritated. Perhaps they feel tired, with limited energy. The pain can lead to inactivity, financial worries, social isolation, and pessimism, (the idea that bad things will happen in the future). This, in turn, tends to make the pain worse. This is known as the vicious cycle of chronic pain.

How you perceive your pain can predict how you will cope, and how much you will benefit from treatment. Having unrealistic or negative thoughts contributes to more pain and emotional distress. There may be many exaggerated and wrong ideas about what the future will hold. Constantly thinking that the pain is getting more severe, and dwelling on the thought that you may be unable to care for yourself in the future, may only make your condition worse. Pain experts have discovered that people who are not too anxious, worried, or depressed, have strong social support, and a generally optimistic outlook, are better able to be distracted from the pain, keep a more objective, realistic outlook, and find good ways to actively cope with their pain.

Learn more about what you can do in the lessons and articles offered in this program. Ultimately, getting a better understanding of how you perceive pain, your personality, family history, and level of emotional distress, can have a big impact on the way you deal with pain.


Caudill, M.A. (2002). Managing pain before it manages you. New York: Guilford Press.

Field, B.J. & Swarm, R.A. (2008). Chronic pain: Vol. 11. Advances in psychotherapy – evidence-based practice. Cambridge, MA: Hogrefe & Huber Publications.

Jamison, R.N. (1996). Learning to master your chronic pain. Sarasota, FL: Professional Resource Press.