The brain keeps the score and the body is the scorecard—a phrase that encapsulates how deeply intertwined our mental and physical experiences are, especially when it comes to pain. As a mental and physical evidence-based pain coach, I see this connection play out daily. Pain is not just a physical sensation; it is a whole-body experience shaped by our emotions, thoughts, and past traumas. Understanding how the brain and body communicate, and how that communication can go awry, is essential for effective pain management.
The Brain and Pain Perception
Pain begins in the brain. When we experience injury or illness, the brain receives signals from nerves in the affected area, processes them, and then decides how much pain we should feel. This process isn’t as straightforward as it might seem. Emotional stress, past experiences, and even our beliefs about pain can alter how the brain interprets these signals.
For instance, research shows that individuals with a history of trauma, anxiety, or depression often experience more intense or persistent pain. This is because the brain “keeps the score”—it remembers past stressors and traumas, which can increase sensitivity to pain in the present. If your brain has learned to associate certain emotions or situations with danger or discomfort, it may amplify pain signals in an attempt to protect you, even when there’s no immediate physical threat.
The Body as the Scorecard
While the brain interprets pain, the body is where the pain manifests. Chronic pain, in particular, can be seen as the body’s “scorecard,” reflecting not just physical injury but also the cumulative impact of mental and emotional stress.
Think about someone with chronic back pain. While their MRI might show a disc herniation, many people with similar imaging results don’t experience pain at all. What’s different? Often, it’s the body’s response to stress or unresolved trauma that causes the pain to persist. Muscles tense up, posture changes, and even breathing patterns shift as the body tries to protect itself. Over time, these physical responses become habits, and the pain becomes chronic.
The body also holds onto unprocessed emotions, which can manifest as physical discomfort. For example, tension in the neck and shoulders is often associated with feelings of responsibility or stress, while tightness in the chest can correlate with anxiety. This is the body’s way of reflecting the “score” the brain is keeping.
The Power of Neuroplasticity
The good news is that the brain is malleable—it can change. This is where evidence-based approaches to pain management come into play. Through practices like cognitive-behavioural therapy (CBT), mindfulness, and movement-based therapies, we can help the brain rewire how it responds to pain.
Mindfulness, for instance, helps clients become aware of how their thoughts and emotions influence their pain. By breaking the cycle of negative thinking and stress, they can lower their pain intensity. Similarly, guided movement, such as yoga or gentle exercise, teaches the body to move without fear, helping to retrain the nervous system to interpret sensations more accurately.
Integrating Mental and Physical Approaches
An evidence-based approach to pain requires looking at both the brain and the body. By helping clients understand that pain is not just a physical issue but also a mental one, we empower them to take charge of their recovery. The brain may keep the score, but by addressing the underlying mental and emotional factors, we can help the body rewrite the scorecard, leading to better pain management and overall well-being.
😊 A Smile and a Thought 🤔
When it comes to pain, the brain's like a referee—sometimes making calls you didn’t even see coming
“To heal is to touch with love that which we previously touched with fear.” - Stephen Levine
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