By Dr David Loe
If you read my last post, you’ll remember that pain isn’t a simple “ouch.” It’s a story—one that your brain writes, edits, and sometimes replays. We talked about context, emotion, memory—the full sensory symphony that makes up what we call pain. Now let’s talk physiology.
Pain is in your brain. The often overused, over-simplification of pain being in “your head” leads many suffers of chronic pain to feel dismissed, as if their pain is fake. But neuroscience tells a very different story. Pain is 100% real. It’s just that the “realness” doesn’t start and end where you think it does.
When you step on something sharp, tiny sensors in your skin instantly send danger messages racing up your spinal cord to your brain. It’s like an express courier service delivering an urgent alert. Your brain receives the danger message and helps you react fast. In this case, you’ve stepped on something sharp and so you may stop and check for injury. But here’s the fascinating part.
When you stay calm and in control, your brain can turn down the volume on those danger signals. It releases its own natural painkillers — hormones like endorphins and serotonin — that calm the message before it reaches full intensity. It’s your body’s built-in pain dial, designed to soften the signal just enough so you can still move, think, and respond.
This is why your pain depends not only on what happens to your body, but on what your brain believes is happening to your body. The brain is constantly weighing the evidence you give it.
So when someone says, “It’s all in your head,” I want you to hear this instead: “It’s all in your brain”…and that means you can manage pain. Because the same brain that can turn the volume up, can also learn to turn it down. Practices like mindfulness, stress management, gentle movement, and pacing aren’t just coping strategies; they’re ways to train your brain to manage and dial down pain.
✨ Next up: we’ll dive into the “tune of pain”
