By Dr David Loe
We’ve all had an earworm ‘stuck’ in our brain.
Maybe it’s Baby Shark. Maybe it’s a ring tone jingle (staring at ‘crazy frog’). Whatever it is, it’s stuck, it’s catchy, and it’s repetitive.
Now, imagine that song is your pain tune.
It’s persistent and loud – maybe it even feels like the volume knob is broken. And like most tunes, it’s not just one single note; it is layered with meaning. Think of your pain like an onion (they have layers and yes – they make you cry!). When you hurt, you aren’t just dealing with tissue damage. You are dealing with four distinct layers.1
1. The Core (Nociception): The Spark
This is the raw data. Nerves in your back or knee send a “danger” signal to the brain. Crucially, this is not pain yet. It’s just information.
2. Layer 2 (Perception): The “Ouch”
Your brain receives the signal and decides how dangerous it is. It checks your history, your mood, and your environment. If your brain decides you are unsafe, it can produce pain to make you protect yourself.
3. Layer 3 (Suffering): The Story
This is the emotional heavy lifting. It’s the fear (“is this forever?”), the frustration (“why me?”), and the anxiety.
4. The Outer Skin (Pain Behaviour): The Show
This is what the world sees. The limp, the groan, the cancelled dinner plans, the staying in bed.
Here’s the kicker: The outer layers can actually amplify the core. When we panic or catastrophise, our nervous system can become hypersensitive. It turns up the pain dial.
So, what can we do?
1. Watch your thinking
Neuroscience tells us that thoughts are chemical events. If your internal monologue is screaming, ” I can’t do this,” your brain floods your system with stress chemicals (cortisol and adrenaline), which keep your nerves on high alert. When the “Danger Talk” starts, interrupt it. Try adopting a voice of encouragement.
2. Master the art of pacing
Don’t overdo it. If you push too hard, you bust. Know your limits and work within them. Take your time, find a steady rhythm, and manage your pain.
3. Drop the Rope
Our struggle with chronic pain can feel like a tug-of-war with a monster. The harder you pull (trying to force the pain to stop), the more exhausted you become, and the deeper you get pulled into the pit. Try to “drop the rope”. Dropping the rope doesn’t mean the monster (the pain) disappears immediately. It just means you stop fighting a war you can’t win by force.
When you stop obsessing over muting the noise, your hands can now become free to do other things—like hugging a loved one, starting a hobby, or getting back to work. You can choose to play the tune of your life alongside the noise of the pain. Eventually, the life track gets louder than the pain track.
- Loeser, J. D. (1980). Perspectives on Pain.
