An analogy to help you understand pain
When it comes to pain, we often focus on the body part that hurts – the tissue we can see, scan, or stretch, and all the factors that influence that being made better (surgeries, massage, stretches, etc).
But modern science tells us the real decision-maker isn’t the tissue at all – it’s your brain. This isn’t to say it’s all in your head, nor is it to say interventions that make your tissues better are unwarranted, but instead to say that your big beautiful supercomputer between your ears is the decider of whether or not something is in pain – a process that happens beneath your consciousness and thoughts.
This becomes even more complex when pain becomes stubborn and lingers for a long time, or doesn’t heal within the normal timeframes that you’d expect it to. In these cases, it often becomes even less and less about the tissues, and more about the other things your brain is weighing up.
What are these other things it’s weighing up?
To help explain, I like to use an analogy, called the Brains Magic Pain Box
The Brain’s Magic Pain Box 🪄
Inside your brain, imagine there’s a small box where your pain decisions are made – that’s to say, a mythical area you cant see inside of that crunches all the data and makes decisions on the pain you are feeling (technically there are 4-5 ‘boxes’ in your brain that do this but lets not let science get in the way of a good analogy). I like to imagine it as a CPU unit with cables running in and out.
Here’s how it works:
1️⃣ Inputs go in (signals from your body, your environment, your thoughts, your stress levels… more to come on this).
2️⃣ Some magic happens
3️⃣ Outputs come out (pain, or no pain, lots of pain, or a little pain, sharp pain or dull pain… etc).
What happens in the magic box? Well, magic! Something you’re not aware of, and can not see. We only know the inputs and outputs
It’s a bit like speaking. You think of a word, and before you know it, you’re saying it in full sentences with decent(ish) grammar. This would go like; 1) Think of a word > 2) Magic > 3) Words come out
What you don’t see is the 230 microscopic and fast tracked steps in the ‘Magic’ section your brain runs through to turn “idea” into “spoken sound.” (don’t show a speech therapist that number – all I’m tryna say is… it’s a LOT of steps)
Try it now – think of a sentence and say it. Did you plan every step? Are you considering the position of your mouth to make that sound? Are you ensuring adequate pressures past your larynx? Are you adjusting your tone to suit the mood? Did you think about the grammar or ordering of those words? How about the social context of the word and if it’s the right one to use? A LOT just happened that you didn’t plan out consciously – you just got the output you needed ✨
With pain, the same thing happens in the Magic Pain Box section of your brain. You don’t consciously run the calculations – you only see the end result: pain, or no pain.
And helping understand the inputs and how they effect the output (pain) can go a long long way in your recovery.
So What Are The Inputs?
For your brain to decide “this hurts,” it has to weigh up information. In short, it is trying to work out if this is a danger to you that needs your conscious attention or not.
It’s being clever, and it’s trying to help you in the context it’s in. Something is telling the ‘Magic’ section of the process that this pain needs to be front of mind for you.
To weigh up this information, your brain is constantly and efficiently scanning the situation for things that are of perceived danger, and things that are of perceived safety to use as important data in the Magic Pain Box.
Here it is super important to note that danger and safety inputs are highly specific to your own pain experience – below I will list a few of the most common ones to highlight a bit about how wide reaching this system is, but keep in mind the intimate and personal nature of pain in your context.
Common Danger Inputs:
👉 Fear of a poor prognosis
👉 A loss of self-efficacy (/self confidence & independence)
👉 Poor tissue health or injury
👉 High levels of stress and anxiety
👉 Reduced sleep levels
👉 Reduced exercise levels
👉 Lack of social support
👉 Past bad experiences with pain
Common Safety inputs:
👉 Hope of a good recovery and reassurance
👉 Improved self-efficacy (belief in your own ability)
👉 Improving tissue health
👉 Reduced stress and anxiety
👉 Adequate sleep
👉 Adequate and safe exercise levels
👉 Supportive relationships
👉 Past recovery
The Magic Pain Box takes all of this (and more) into account and makes its decision. That’s why pain can feel unpredictable and at times mysterious – it’s assessing a lot more than just the physical tissue state, and it’s doing most of it without your knowing or direct input.
Why This Is Hopeful
At first, this can feel overwhelming – so many different inputs, so many moving parts. But here’s the hopeful bit:
If you can’t control the Magic Pain Box itself, you can influence the inputs.
That means you actually have plenty of levers you can pull to change the outputs over time to help convince the Magic Pain Box that you’re safe.
Which gives you plenty of options of places to start when pain lingers and wont go away.
Inputs you can start working on
Here are some key pieces of the pain puzzle that you can start to try when the usual things aren’t working anymore:
👉 Safety & Confidence – Actions, thoughts, help from medical professionals that make you feel safe and confident on your journey.
👉 Self-efficacy – Building the belief that you can influence your own health, and choosing interventions that build you up
👉 Graded exposure – Slowly returning to activities you’ve avoided, step by step.
👉 Tissue health – Strengthening muscles, improving mobility, supporting recovery.
👉 Social health – Being around supportive people and staying connected.
👉 Sleep – Giving your body and nervous system the best chance to recover.
👉 Overall body health – A well-nourished, active body regulates inflammation and immunity better, which feeds back into the pain system.
Even small changes in these inputs can shift how the Magic Pain Box responds, making pain less likely or less intense over time.
Takeaways
Pain is complicated, but it’s not random. Your brain is always weighing up danger and safety inputs in its little pain box. While we can’t tinker with the box directly, we can adjust the inputs – through movement, good care, reassurance, and support. Anything that makes you feel good, safe and challenged in all the right ways!
So if your pain has felt like an unsolvable mystery, remember this: the box might be hidden, but the levers are in your hands. Even small, consistent adjustments to the inputs can make a big difference over time.
