If ‘Pain Is an Opinion,’ There Are Ways to Change Your Mind

All pain is real, but it’s also true that it’s “made by the brain” and that we can exert some control over it.

Comments: 145

  1. As Nietzsche noted, pain and pleasure are epiphenomena

  2. Has the author of this piece consulted with sufferers of neurofibromatosis? As a chronic pain sufferer, who works hard to overcome pain and limit the use of opiods, I found this piece to be insulting. The author has absolutely no idea of what chronic pain is. Chronic nerve pain is unrelenting.

  3. Oh no. Pain is a bear. A big, mean bear with yellow fangs and sharp claws that gets hold of you and doesn't let go, not even to take a breath. Ask anyone who has suffered chronic, intractable pain. Going to a hospital or a place of safety doesn't make the bear let go. Nothing does. Nothing will.

  4. Yeah, bring back real painkillers, please. I don’t look forward to two more decades of “imagined” pain. I might as well be dead at this point.

  5. "...pain is communicated from that source to our brains by “pain nerves.” That’s so wrong it’s called “the naïve view” by neuroscientists. Philosophy's "naive realism" says true/real sensory experiences copy the world as it is. But our bodies are R2T2T2--twice Receivers, Transformers/Interpreters, Transmitters. Sensory organs Receive external input (light waves, sound waves, gases etc.) Transform them into electrical waves and Transmitted to a brain; it Receives, Transforms and Transmits waves--down the spinal chord and into the atmosphere. Brains also Transform/Interprets inputs as signs/representations of what is happening on/in/out of our bodies. These are often "projected" as if happening at the input source: colors, sounds experienced as "out there," flavors in the food, itches, tickles and pains as on or in the body. Synesthesia is multiple reception. "Referred pain"-- is deceptive--experienced elsewhere; so is "phantom limb" pain--projected to newly missing limbs--because the brain is still navigating with a old body-map. "In truth, pain is in our brain."This is "naive neuroscience": no brain dissection will ever find the pain. Consciousness is is a brain product/transformation, not a brain process.

  6. If pain is "just an opinion of the mind," then I presume sexual pleasure -- or any kind of pleasure -- is as well?

  7. @Hypatia your point is on mark ... there is a philosophical opinion that much of this life is an illusion. Everything that is relative (beauty, ugliness; even pain and pleasure) would be part of that illusion. It is said that when you meditate one can see for themselves what things are absolute and which are relative ... my understanding is that when one becomes enlightened (to this philosophy (reality) then one can stand like a witness to this illusion playing out ... Sex and the question reality appears (for me) what the story of Adam and Eve (specifically Milton's Paradise Lost) are hinting at.

  8. @Hypatia An entire branch of philosophy deals with nature of reality: metaphysics. Try a philosophy easy to understand : Buddhism.

  9. @Hypatia Yes

  10. One of the past Presidents of the American Society of Anesthesiologists recounted his experience as an infantryman in the Korean War. In his first firefight, he was hit and fell to the ground in extreme pain. When he was brought to the field hospital the physician said there was no injury—only his canteen had been hit. So they sent him back to the field where his unit was still in the middle of a fierce firefight. A short time later he was surprised when two medics started gathering him onto a stretcher. One lower leg had been blown off and he didn’t feel a thing. He recovered and went into anesthesia after medical school because of his fascination with the various aspects of pain; as he said The worst pain I felt was when they hit my canteen.

  11. This is so offensive I don't know where to begin. I have Multiple Sclerosis and have been in constant pain for 20 years. Some times the pain is in the background and I can ignore it. Sometimes the pain is is HUGE and occupies every waking minute. It's not an opinion--it's very real. Chronic, unrelenting pain is terribly debilitating and this articles gaslights anyone who is in that world of pain. It diminishes suffering. If the author ever felt the kind of chronic pain I and other commentors have felt, he might change his mind.

  12. Nine years ago, I herniated my L4L5 disk. I never had radiating pain, only lower back pain. I was told by one doctor that I would be much harder to cure than those with radiating pain. It has now been nine years of living in pain often debilitating, and I take opiates to get thru my day. I listen to meditation music and use mindfulness techniques when pain episodes hit. They do not eliminate the pain but do help decrease it. I have made countless trips to the ED in uncontrollable pain. I have no doubt that the brain has something to do with my pain. The trips to the ED are when the pain is so bad that I have lost my ability to mentally cope and calm myself down when having a significant pain episode. The Mayo Clinic has a Pain Rehabilitation program that I am considering. The programming of nerves and the brain in chronic pain sufferers to signal more pain than exists is well explained in their 13 minute video on their website. https://www.mayoclinic.org/departments-centers/pain-rehabilitation-center/overview. It really convinced me that I can decrease my pain and decrease or eliminate my use of opiates.

  13. @Cavanaugh, unfortunately opiates do a number on the mind and brain, so don't expect too much from that. It numbs not only the pain. Having said that, I hope and wish you a full recovery rather yesterday than tomorrow.

  14. @Cavanaugh I was in impossible pain from my lower back and I found a small group training gym (same as a trainer, but less expensive) and got to work strengthening my core. This was after chiropractic and acupuncture didn't help in a sustained way, I was tired relying on opioids, and I rejected surgery. It took a few months but I have been 100% pain free for years now. Lower-back pain is the devil. Please see if core work can help lessen your pain.

  15. @Cavanaugh This video is such a great resource . I am marrried to a man who used to bike, play tennis, hike, travel, work in the yard,etc...and now, he is sort of "paralyzed" by a multitude of pains & distressing symptoms. I am begging him to watch the video in hopes it will bring some relief.

  16. Pain is not the consequence of negative emotion, it is the cause of it. A person with acute pain becomes anxious and frightened. A person with chronic pain becomes depressed. Although anxiety, fear, and depression may increase the sensation of pain, to believe these emotions are the cause of pain is the same as blaming the person for being in pain. It's like saying if you only thought more positively, you wouldn't feel like that. This is insult ing to anyone who has ever suffered from any kind of pain, such as a burn, from migraine, from cancer, from a fall or a stubbed toe, or from agonizing back pain that wakes you in the middle of the night.

  17. @Sarah I suffered from debilitating chronic pain for 30 years. After learning about the mindbody connection ("Healing Back Pain" by John Sarno) I finally cured myself of it. Never did I think, even for one moment, that any of it was my "fault." I didn't ask for it and never wanted it. But it was my "responsibility" to find a way out. None of the many doctors, chiropractors, and other therapists I consulted were able to do for me what I had to do for myself: acknowledge that, indeed, my emotions were hiding behind the pain. In fact, all emotions are felt physically. When you're nervous you get butterflies in your stomach, when you're angry maybe you feel tightness in your chest. Chronic pain (that is not due to cancer or a recent injury) is a manifestation of the emotions we don't yet understand. This lack of understanding is perpetuated by the widespread incorrect diagnosis and treatment of chronic pain conditions including back pain, fibromyalgia, and other "unexplained" pain in the body. Several decades ago Dr. Sarno predicted that we would see a chronic pain epidemic in this country precisely because of the way we mis-diagnose and treat it.

  18. @CKW I am happy you were able to cure yourself: this may not be so for everyone and no one should feel the less for it. I maintain that physical pain has a physical source and causes emotional pain. Articles such as this one make people distrust what they feel or make them angry that their pain isn't recognized for what it is. Articles such as this blame the victim, sad to say.

  19. As someone who has been in chronic pain for over 1/2 my life (I’m almost 50,) because of illnesses ranging from cystic fibrosis, migraines and facial pain known as the suicide disease, to 2 cervical neck fusions and multiple genetic and auto immune diseases; i have many strong opinions on this matter. While Indeed some pain can be mitigated by distraction and mindfulness techniques, the tragic reality is that lots of pain that is not just cancer pain is only relieved with judicious and careful use of opiates. In this new war on opiates world, those people with chronic & debilitating organ and many other painful conditions are the tragic victims of a widespread societal prejudice based on a misinterpretation of pain because of the opioid epidemic. Let’s be adults and not naive and realize as with anything medically complex there is never a simple, one size fits all solution.

  20. I always find the old adage "Walk it off" is a good start. it can take your mind off of the pain. But I find doing something i enjoy, such as cooking redirects my thoughts and I pay less attention to the pain. But I most also admit most people tell me I seem to have a high tolerance. The mind can make Hell out of Heaven, and Heaven out of Hell, use it well.

  21. The article makes a valid point that some pain can be reduced by concentrating on something else. I have found that to be possible in some cases. For me, music can be a distraction and a calming influence for certain kinds of pain. So can things that make me laugh. The author is not putting down those with chronic pain.

  22. @Katie Totally agree.

  23. Sometimes it seems that propaganda overwhelms us from a place of pure sadism. Sometimes it seems as though this drug crisis has been brought to us from the same place for the ultimate purpose of inflicting pain, first by addiction and then, later, by withholding relief from those with real, agonizing pain. You have to wonder who's getting all the money--and writing all the articles. (Even thought is physical, by the way.)

  24. This is exactly my experience. I suffered from chronic back pain pain for two years. I was diagnosed with three herniated disks. The neurosurgeons wanted to operate-I refused. After two hospitalizations, taking ibuprofen every day for eight months, physical therapy two times a week, being on sick leave for 12 weeks and four weeks in rehabilitation for back pain I finally found Dr. John Sarno‘s book. I found it after reading a review in the NYT about a film that had been made about him. I downloaded the book, read it in one setting and got off the pain meds that day. The pain was still there but finally my fear of the pain had lessened. After applying Dr. Sarno‘s principles and working with a psychotherapist trained in Dr. Sarno‘s method and applying Dr. Claire Weekes principles it took me 1.5 years to be pain free. It still returns sometimes and it usually is when I feel anxious or tense. The herniated disks are still there but they have nothing to do with my pain. In my experience you can truly retrain your brain. In the process I have learned to manage anxiety and enjoy my life a lot more.

  25. @Astrid Understand that Sarno's materials have been helpful to many individuals. It also helps to bear in mind that one system that emotions get channeled into are the skeletal muscles which increase tension. It is possible that structures which had been injured and subject to degenerative changes (the understood medical progression for disc injury over time) are more likely to be painful when muscles are under increased from tension related to activity or emotion. Reviewing Sarno's writing his expertise on emotions is interesting for an individual who has no formal mental health or therapy training or learning. Most of the more recent understanding of emotions in trauma or other situations views them as very much embodied states. If dysregulated emotions were the whole story on pain-- teenagers would be crippled and unable to move

  26. @Astrid gret to read your positive comment! Dr Sarne treated folks on my floor of a rehab hospital in NYC 1979! I took a neuroplasticity group that was really helpful. Been 2 years i've been successfully employing tools at the first sign of substance p.

  27. Pain is designed by Nature for survival. If we focus our attention, attention being the key word here on the pain, we increase the pain. If the attention is directed to something else, like a secure environment, or music, or anything relaxing other than the source than it can be lessened, based on your ability to keep the focus off of the pain. We can make any human condition better or worse based on how much attention we give it. If emotions are allowed to replace sound judgment than the outcome can be greatly exaggerated. Understanding how much attention we give any pain is crucial to stabilizing it. In combat or emergency situations, pain can be diverted to an extent that the attention is allowed by practice of diverting the focus. Understanding that the body was designed to communicate or be made aware of any injury to it, is the first step, and then managing the injury or illness, knowing it doesn't have to be any worse than pains basic acknowledgement is crucial. Stop thinking about pain which only give it fuel, and accept it by slowing the thought sequence of any emotional aspect that may cause the pain to get worse. It's just a signal to bring your attention to it to address, but only for the time it takes to access the damage, and then do the steps to handle it and stop the worrying process by making little of the pain, telling yourself, "ah it's not as bad as I thought it was", which pulls the focus off the panic of, "oh my God", what am I going to do now.

  28. @Jerry You are so right. My Facebook group follows this thinking: Chronic Pain Champions - No Whining allowed.

  29. Something was going on with my foot and the pain got worse over 6 months til I was limping and cramping and every single step was intense. X-rays showed nothing. When I finally got an MRI it showed a small ligament tear that was healing, my orthopedist started talking about surgery, but he wasn't sure it would help--and I'd be off the foot for 3 months, which sounded terrible. My physical therapist had me download the app "Recognize Foot." It's been 3 weeks since I've played the game on the app a few times a day and my pain is down a good 70 percent and surgery is off the table. As PT explained to me: Sustained chronic pain had caused my brain to see everything as a threat. In ways I can't elucidate (because I don't understand them), playing the app calmed my brain down. Very thankful for Recognize Foot and VERY thankful for my PT.

  30. @Orange Soda great perspective, thanks!

  31. I think the issue for those of us with chronic pain is the feeling that the article is saying "it's all in your head" aka "not real" aka "a personal weakness", etc. This, in my experience, is the classic response from much of the medical community when faced with something they don't understand or don't know how to fix. It makes more sense if you acknowledge what you see is also an opinion, hear, feel, taste. In all cases, impulses travel to the brain and are interpreted there. When someone says something and you misunderstand, the sound waves came into your ear canal - it was your brain that didn't figure it out correctly. The data comes into the brain as neutral inputs. The brain interprets, but like the rest of us, sometimes it misinterprets what the body is trying to communicate. The medical community, and science as a whole, does not fully understand the brain's functioning. If the techniques discussed in the article and the comments below work for you, I think that is a wonderful thing, but it isn't a one size fits all, nor does it diminish the pain experience of those for whom these techniques do not work.

  32. @Tasha-Kitty You aren't wrong that this is the common response when doctors can't find an answer. However, these days, patients refuse to accept that there is nothing diagnosable wrong (i.e. they can't fix you).

  33. Pain is an opinion? I think more correctly how to deal with pain is an opinion. And I really dislike the current opinion to withhold the methods for dealing with chronic pain that have been proven and that work the best. As long as they are not abused, are used sparingly, and as prescribed. They work the best. Of course all the available options, therapies, and drugs should be considered. But why should society force an opinion onto others that are in pain if they have tried all the therapeutic options available and have come to their own opinion as to what works best to manage their own pain?

  34. Pain is similar to art. Everyone experiences it differently. I find much modern art to be boring and nauseating, obviously millions feel otherwise. I've had some experience with pain. Recovery from cancer surgery to the throat and radiation treatment was the worst. The chronic sever pain lasted the better part of a year and was excruciating. Yet, when I went to work and meetings, it seemed more manageable. At home it was not. Gallstones were just appalling. You lie down and hope the pain will diminish even slightly. I recently broke my neck, and stirred up all the arthritis in my back in an accident. The worst part was the phantom nerve pain from spinal cord damage. I felt like both of my arms were broken badly. The pain was bilateral, symmetrical, and phantom from the spinal cord bruising. There were no injuries to my arms. My conclusion. Sometimes pain hurts worse than others. Hope that helps.

  35. I am skeptical of the current trend towards the 'cerebralization' of pain-- it would be a bit odd for medicine to treat conditions which are also susceptible to emotions-- blood sugar, blood pressure or immune status in cancer-- by prescribing positive thinking alone. Much of the argument developed by Moseley and others interestingly focuses on exceptional cases-- more emergency room physicians spend time removing real-- rather than imagined nails from feet. Moseley and others neglect to mention those conditions of congenital insensitivity to pain which lead to early death from bodily injury. Conditions such as degenerative conditions of the hip or knee have been relabeled as medical when treatments have been developed as opposed to mental complaints. The late Susan Sontag wrote powerfully on this trend in medical diagnosis. Better yet would be targeted research into areas such as aging and regeneration. Cancer treatment has been transformed by use of stem cell treatment to manage previously untreatable conditions. Managing suffering is the humane thing to do until research moves forward into these areas.

  36. My son was told by a doctor to do "music therapy" for pain that was caused by a needle stick. He had a severe reaction to a procedure that was alleged to "bring blood to the surface to help it heal." What he actually had was an undiagnosed broken leg and severely torn cartilage, which is probably why the "fenestration with a 27 1/2 dry needle" had such a bad effect. He does not take medications but the pain has not gone away and things like "try to do something else" or "think about birds and flowers" really do not work. I am quite skeptical about the "positive thinking" trend, especially when it precludes measures like taking an x-ray.

  37. Some pain truly cannot be mitigated by mind techniques/positivity/etc., and as others have mentioned, pain is often a signal of something very wrong. I think most of us have, on our own/not among us all, had diverse pain experiences, from acute unimaginable pain to chronic low-level pain. As a blessedly overall healthy and active middle-aged woman, I have had lower back trouble (multiple herniated, bulging and torn disks) and sciatica for about a decade. I can actually tell my pain "NO" when it acts up, especially, for example, while I am running and otherwise blissful. It works.

  38. @Jane Bond i have a disability from a long car accident and all sorts of issues but my back probs (including sciatica) were alleviated when i inclined my bed 13 months ago. Check it out; 6 in blocks or furniture risers under the frame of bed at the head creates an approximate 5 degree long incline (sleep head higher than feet) and gravity works its magic while you sleep. Circulation and all other systems' functions are improved. How can you tell it's good for a body? After sleeping inclined, if a person sleeps flat they feel like they've been hit buy a truck and are all puffy in the face; it obviously beneficial. Western medicine will never tell you about it b/c there's no financial benefit in it for anyone. Check it out, www.inclinedbedtherapy.com

  39. @Jane Bond Just say no. I have heard that one before.

  40. <> In my experience, this is not true. Years ago a plaster cast had to be applied to my injured leg. I was asked to relax the leg, and that's what I did. The medical team commented that the leg felt like that from a dead body. To me it felt just heavy with no other sensation.

  41. Cool, next time I have surgery I will just positive think myself through the whole thing without anesthesia. Pain is REAL. The difference between acute pain and "chronic" pain is that you just suffer acute pain a billion different times.

  42. @Samantha Acute pain resolves but can burn pain into the neural pathways where it may remain; that's chronic and those pain pathways can be broken and replaced with pleasure pathways. That's neuroplasticity and it works.

  43. @BostonGimp It's true. I've had fibromyalgia twice. The first was relatively minor and lasted about 5 years. The second was severe and lasted about 1.75 years. Both times, I eventually got on with life and it gradually went away. However, I also wholeheartedly adopted Dr. John Sarno's theory/approach re: pain, TMS, Tension M..... Syndrome. If interested, there's lots of info/resources online. It has saved my life - and is both the worst and best thing that has ever happened to me.

  44. @BostonGimp Exactly!

  45. So, sometimes to get back to an article when I've been following the comments, I just google it. Typing "pain is …" into google was illuminating. Google's many suggestions are below. I would say this suggests we are really, overall, quite uncertain as to what pain is. The possibilities are all over the place, scientifically, philosophically, theologically, culturally. Pain is an illusion Pain is an old friend Pain is a necessary investment for progress Pain is a sign of progress Pain is a gift Pain is a very subjective experience Pain is a virtue Pain is all in your head Pain is temporary Pain is inevitable suffering is optional Pain is weakness leaving the body Pain is good hot sauce (???) Pain is beauty Pain is love Pain is relative Pain is an emotion Pain is an excellent teacher Pain is in the mind Pain is an example of medical terminology A Times article in March of 2019 asked if pain is an "emotion," or a "sensation." So there's two more possibilities. Do we really have any idea what pain is?

  46. @DW When I broke my femur, I was of the opinion that it hurt. Somehow that just doesn’t tell the story.

  47. Neurons send signals to the brain telling us something is dangerous or to stop doing it.

  48. To my fellow pain sufferers: not only do I believe you, I’m with you all the way. Keep fighting the depression that comes along with chronic pain. Keep trying any new ideas that are reasonable to get relief. The idea that it’s in your head isn’t helpful, and only a person who has never had chronic pain would waste time with that kind of “information.” NYT: we want you to publish articles with a glimmer of hope, with new ideas, and more empathy.

  49. i don't believe that pain, especially chronic pain as i have, resonates from the brain . say all you want about studies and experiments, pain comes from pain site. and the resulting depression is all too real, as well. sadly, it creates an entirely different personality than what you were before, and if you get no relief from whatever source you are trying, all the sadder. my son just called my pain an"ad nauseum" issue because i couldn't ever make him relate. but how can you?

  50. I need words more powerful than I can imagine. I am assaulted by this kind of assertion. An opioid prescription has improved has improved the quality of my life immeasurably for decades. In my 20's, I was in a car accident that destroyed two discs, damaged both sides of one vertebrae, and one side each of the adjacent two. I’m nearing 65. I have had chronic pain since that accident. I have a brave GP who prescribes me an opioid in this witch hunt environment. I sympathize with addiction problems, my wife is an alcoholic. I will never abuse this med. I need it too much. I feel like I am groveling when I need a new script. I feel like a criminal when I go to the pharmacy. I’ve tried so hard, at so many drug free ways to deal with this pain, I can't list them. I have found some but marginal benefit from nearly every approach. I have been told that pain might be “in my head” by various specialists. I’ve tried numerous meds. Nothing else works well. I have spent countless hours, for decades, faithfully working out and stretching. I have an amazing wife who learned to massage. She was the most effective treatment of all. In the last ten years her hands/wrists have become too arthritic to massage. When I was about 55, I had hernia surgery. It stopped me from exercising. To my shock, the pain was no worse. I cannot object strongly enough to pain being categorized as conjered up and controlled by my mind.

  51. @Richard Fisher You're not alone. I've lived with chronic pain for 50 years. It doesn't matter what I do or don't do, I'm in pain. Happy or sad. Life is great or everything is wrong. Doing things I love or doing what I hate. Sitting, walking, or laying down. I'm always in some degree of pain. 24/7 - even in my sleep. Sometimes it's not as bad, sometimes it's more than I can stand. I've done everything and anything to feel better. I am constantly on the search for anything that can help me. I'm so very tired of being in pain. I've taken the same amount of opioids for 20 years. Not one more. In the past several months they've become less effective, but it's still better than nothing. Like you, I've been treated like a criminal and a junkie. Believe me, I'd do anything, ANYTHING, to feel better. I hope you and I, and all other pain sufferers can find something to help. Being in pain is a horrible way to live.

  52. Ditto! I have had chronic pain for 38 years and it was only when my doctor prescribed hydrocodone 15 years ago that I got relief. When I told his replacement recently that it was time to increase the dosage, I got the blah,blah,blah but she finally agreed. At 78, This old lady has no interest in selling my meds on a street corner or abusing them! The only time when I get depressed is when, every month, I have to call 4 days before to ask for a script and also when Nurse Ratchet insists I take a urine test! I hate being treated like a criminal! I have been going to the same Clinic for over 30 years; they should know me by now! Also, I have a closet full of electric massager stuff that I really need to throw away!

  53. @Richard Fisher Thanks for your important comments. The author says he has pain in his head and hands and feet. How vague. If the author had meaningful significant pain he should describe it. The millions of people like you and me who use opioids responsibly are so fortunate that many doctors are ignoring the propaganda that opioids should not be used for chronic pain.

  54. "The idea that it’s in your head isn’t helpful, and only a person who has never had chronic pain would waste time with that kind of “information.” I'm afraid I totally agree. If it's "in my head" who is telling my stomach to revolt with projectile vomit every 30 minutes for the next 15-16 hours? Does my stomach have a mind of it's own, but only does that when my head feels like I have an ice pick stuck in my eye? We run 18 hours a day, 7 days a week in TV production, I can't walk off the job to do deep breathing exercises. If playing the trumpet or holding hands helps someone, bless them that they find relief in it, but reading the comments, it seems too many are looking for better solutions than what is offered in this article. I would rather read about unaffordable preventatives on the market than these as effective solutions for the majority of migraine sufferers. If I, and many others on this forum, sound cynical, it's because we have known the pain for far too long.

  55. CBD worked wonders for my migraines, which I had for 20 plus years

  56. @Dan M I've heard that inclining a bed helps migraines. I inclined mine a year ago and have had lots of great health changes (thankfully i do not get headaches). www.inclinedbedtherapy.com

  57. @Jay I couldn't agree more as a migraine sufferer myself. Although music therapy is an interesting alternative solution, noise is the last thing we need. Help us find something else.

  58. I must say that the proposed cure here is all in the doctors head.

  59. Dangerous perspective that appears widely shared by too many medical professionals. It inevitably leads to the perspective that pain is a "choice," that patients' pain is exaggerated (aka "fake pain"), that babies and children don't feel pain (an all-to-real perspective that dominated medicine for years), and that women and minorities (especially) don't "really experience pain" (like white men, of course). Pain is there for a reason - it's designed to tell us something is wrong with our bodies. It's also clearly designed to remind us something is wrong if we encounter a medical "professional" intent on trivializing it and telling us, yet again, that it's all in our heads.

  60. Yep. I know of two women- my grandmother and my friend’s mother who had male doctors that told them their pain was all in their head. They both died of cancer.

  61. Although the distinction isn’t helpful, it’s a fundamental fact that pain is “in your head.” It’s not like taste, smell, temperature, sight, hearing, touch, etc where there is a distinctly fundamental stimulus in the external world that you are interpreting. Pain is internal to the body and mind. But this distinction doesn’t mean that pain isn’t real

  62. Wait - so if you burn your tongue that’s not real? Or cut your finger ? Pain is real.

  63. @Stefan Pain is a distinct sensation, along with the other sensations you list. The sensation is an "unpleasant" one. The experience of pain reflects activation of our nociceptive ("harm detecting") apparatus, just as the other sensations reflect our awareness of activation of their respective apparatuses. Activation of the nociceptive apparatus can result from tissue damage but we now have good evidence that it can also result from processes operating within the central nervous system known as "neuroinflammation".

  64. I have trigeminal neuralgia, the source of my pain can be seen on a MRI. But I'm more then open to alternative therapies, as opioids don't work for nerve pain. That being said, dear doctor, please don't compare your kidney stones or stiffness to phantom limbs. That kind of thing is why pain patents suffer

  65. @Christina I hope you get proper treatment...I had trigeminal neuralgia some years ago...misdiagnosed for months, until I finally saw a neurologist (who confirmed what I already knew: the pain was an 11 on a scale of 1-10)...he immediately knew what it was and prescribed Tegretol...the pain went away within an hour of my first pill...it has never come back...I truly wish you similar results...

  66. @Christina, exactly! That made me livid as well. I think it’s a particularly male perspective. My husband had a kidney stone incident a few years back, and you would not believe the drama, and how much attention he got at the ER. But when I’ve presented at the ER in excruciating pain, from very real and visible injuries, I am barely tolerated. And when my head is exploding with migraine and I am blinded and vomiting, Mr. Husband sees it as just just another headache. Ugh. Don’t get me started. I, too, suffer from trigeminal neuralgia, and TMJ. I have found that Botox injections into the masseter muscle calms the nerve somewhat by stopping the jaw clenching and muscle spasms. I wear a plastic retainer at night some of the time (a bite guard was too big and made the pain worse). I take oral magnesium and soak in magnesium baths. Icing the jaw helps tame the nerve temporarily, but calming the muscles around it helps in the longer term because your body will tend to tighten up around a painful joint.

  67. I live with supposedly chronic pain from arthritis and joint damage but learned how to mentally block it very early in life. Unless it suddenly flares, the low level constant pain is just something I live with and do not notice it. I do notice it when I get done with work for that day and stop moving. Approaching 70, the lifetime of wear and tear is just part of aging.

  68. Incredible article. It explains why we can’t understand opposing arguments to our opinions when we feel very strongly about something.

  69. I have chronic, severe pain from degenerative disease and have tried several alternative approaches, none did much. No amount of wishful thinking stops me from waking up at 3:00 AM when my knees/wrists/feet/etc. start to throb or my previously broken back starts to spasm. Yet I have become accustomed to it, to the point I mostly don't notice it because I'm too busy working - can't take those meds and work. But only if the pain isn't too bad and I'm completely distracted. Doesn't work at night.

  70. @rbyteme Your pain sounds severe. I also have degenerative disc disease, and as you may be aware, I is common in most everyone as we age. One of the major points of the article is pain is not usually directly correlated with a structural issue. Pain is real but sometimes it can’t be found on an MRI. It sounds like you have pain in other joints as well. I use a combo of meds, anti-depressants, exercise, meditation, getting out into nature but the biggest thing was accepting that I may always have some level of pain and I stopped trying to chase the source of my pain. Hope you keep trying a myriad of things to manage yours.

  71. @Pam Pain is never visible on an MRI nor on any other available imaging process. It is an something that is experienced and not a "thing" that shows up when we undergo these tests.

  72. This might help explain the high dependence on opioids in economically stressed geographic areas that have high rates of obesity, chronic illness, depression, alcoholism and/or scant availability of healthy foods.

  73. @Louisa Glasson The author of the article would be well aware of these important social factors as he is a Public Health professional. If changing the opinions of peoples' brains was all it took to solve these problems that are associated with persistent pain, myriads of people from antiquity onwards would never have had to suffer.

  74. There are limitations to mindfulness and self-hypnotic approaches; one can only sustain them for so long. Mindfulness and self-hypnotic techniques require a lot of mental energy and focus. At some point in time, usually later in the day a person becomes fatigued and cannot sustain these methods. That's when there is a role for some reasonable medication. Medication is often necessary if one is to get any measure of sleep.

  75. I got the same sort of relief that Dr. Frakt speaks of when I played the french horn. Of course, I can't exclude the possibility that I was just transferring my discomfort to the people around me.

  76. No mention of child labor and delivery?

  77. Seriously. One of the most painful things a person can experience.

  78. More “cruel and unusual punishment” from the NYTimes! Just the day before yesterday, the dentist unexpectedly gave me an injection that sent a bolt of electricity down to the tip of my tongue. Thought I had been electrocuted by a mad woman who apologized profusely for hitting a nerve. Sorry, but that wasn’t my imagination!

  79. I have both kinds of arthritis and had 3 major spinal fusion surgeries in less than 3 yrs. and prior to that for about 12 yrs I was punished severely as a form of treatment which is still used today. What NO author ever covers is how the vast majority of us are treated when it comes to pain that was in place before our current opioid epidemic. There exists ONLY punishment for those in pain and IF you dare claim you can help yourself you will be branded a drug seeker and addict and THAT is what our entire hateful and homicidal (health care is still the 3rd leading cause of death) system consists of. Until we decriminalize our rotten health care system we will remain a form of slave

  80. The assertions put forth in this article are why patients increasingly fear and loathe doctors and the medical profession in general. Gaslighting patients has become sanctified as an enlightened approach to the practice of medicine when it is really just a way for doctors to avoid the work or risk of their profession re: effective diagnosis and treatment of the patient. It's disgusting.

  81. It’s like the people saying the reason people are poor is bc they are attracting it w their energy. It’s such a privileged way to view the world. If your back is broken you will have pain. It’s not all in your head and the signals are there for a reason. Also trigger point therapy and acupuncture are so helpful but they physically deal w energy movement and nerves. The brain is connected to everything else and we have neurons all over our body. They are there to help us from getting killed !

  82. @Andrea Hawley I do not for one moment believe that the experts quoted in the article are guilty of "gaslighting" people experiencing pain (i.e., getting them to doubt their own sanity). Their beliefs about pain are quite genuine and "neurocentric", a term which could imply the existence of a little man (a homunculus) in the brain who can instantaneously decide whether or not the owner of the brain will experience pain.

  83. I had back pain so bad that I was suicidal. I just wanted it to end. Thnak God for Dr. John Sarno, RIP. I was able to see him in person and he showed me how my pain was real but coming from deeply embedded unconscious memories. It took me three and a half years but I am now 100% healthy and can do and lift anything.

  84. @Walker I always wonder how the late Dr Sarno was able to know that pain could arise from deeply embedded unconscious memories. To be fair, he must have spared many people with spinal pain from undergoing ill-conceived surgery.

  85. Pain is not made by the brain, it is made by an injury. Whether or not a "doctor" can find a cause they will accept as being the source of the pain has no bearing on these facts. Though it is the real issue being skirted here. Doctors being trained to ignore their patients and treat them like they are animals who cannot honestly communicate. The reason for that is the cost of treating someone honestly for something an accountant cannot see.

  86. There is pain and then there is pain. Yes, I can deal with back pain from arthritis without meds, or a headache, but then there is the severe pain many people live with that is life crippling. I know some of these people well. And articles like these that the NY Times continues to publish make it harder for people in desperate need for pain meds to get them.

  87. @Mm How do these articles "make it harder for people in desperate need for pain meds to get them?" Who is stopping the meds? What army is blocking access to your pharmacy?

  88. @Quisitor The point of Mm's comment is that people should not be led to believe that their brain has made a wrong decision that can be changed without the need for medication.

  89. I have a genetic disorder and live with chronic pain. I couldn't live without my opiods and i have tried. I take less than 45 pills a month but also use lidocaine patches, lidocaine cream, marijuana creme and oil, ibuprofen and tylenol. Also have a tens unit, PT weekly, pain injections, ablation treatments, and counseling. Just hush.

  90. I read once of a Buddhist monk who said, I feel pain but I don’t suffer. That has helped me quite often. I still feel a pain, and I realize it’s there to tell me something’s not right, but I don’t feel I need to run for meds. I don’t feel the need to “kill the messenger.” And I have definitely noticed the power of distraction to make pain disappear. Another thing, if it hurts when I move and also when I don’t move, I keep moving.

  91. My primary reaction to this information is; this is new? Opiates don't do anything to repair the source of pain. They simply deaden the brain's perception of that pain. This is something your brain is perfectly capable of doing itself. Pain is simply the body alerting the mind that something is amiss. If the source of that pain is determined to be not something creating further damage to the body, it can be, somewhat, ignored or, at least, moved to a lower degree of awareness, much as when the author plays music; the awareness of pain subsides. It IS all in your head.

  92. Really compelling article, what comes through for me is how essential safety and feeling connected are to alleviating pain. One of the issues w/ regard to depression/anxiety/pain is that people often times seek experiential avoidance as a way of managing issues, and it is the opposite path that brings healing, for some, being connected. Strong writing, fascinating work. Thank you. JGR

  93. The safety factor may explain why tucking yourself up in bed with a heating pad is so soothing. However, I think this article oversimplifies a complex process, to the degree that some of the information is wrong. That is harmful.. Why do we feel acute pain when we sprain an ankle, break a bone, or get a deep laceration? Inflammation of tissue and damage to nerves. the body communicates to the brain that we are injured. Sure, those nerves are not dedicated “pain nerves,” but they transmit sensory data, so our brains know we need to protect the injured area. We are mammals, so like any injured animal we feel hampered and unsafe when injured. So acute pain is real, and useful. But what about “chronic” pain that has a physical source? That is just as real. I suffered for years from neck muscle spasms, upper back pain, neuralgia that extended into my arm, and the almost daily complex migraines that all of this triggered. I believed this was a chronic pain loop that my body created in response to my emotional trauma, because that is what I was told. But then I had a benign cyst removed from the base of my neck, next to my spine. My “pain loop” and spasms disappeared, completely and immediately. The cyst had been pushing on a nerve all of that time, for years. And no doctor, physical therapist, or massage therapist had thought to make the connection, even though the cyst was visible and sitting right up against my spine. Always look for a source. Your body is talking to you.

  94. Trigger point therapy is so helpful! Muscle tension from scoliosis is constant so this has been so good at releasing my muscles. Only hot yoga has taken away the pain completely. It’s a lot of work. Recently I’ve had to have steroid shot into my lower thumb joint in order to work as an artist and Gardener. I could not pinch or grip bc cartilage is worn away from physical labor. The doctor said that it’s not that I’ve lost strength it’s that the body won’t pinch or grip bc it’s pain telling the body not to do it to prevent more pain. So I’m a bit confused. I know that emotional pain can be helped by exercise and mindfulness, most of all the woods and making artwork give me a focus that is calming. I imagine it does this for the body pain as well but I have not found it to work as well as trigger point and f course this shot that enables me to work. I do think the worst thing for everyone is staying inside and remaining inactive. I have a 17 year old dog who has had arthritis for years and she keeps on trucking. I am certain it’s bc she gets to The woods and enjoys the company of other dogs. I see with her that if left in her pain all day with no distraction, she would most likely not still be here.

  95. Dr. John Sarno’s books have helped me rid myself of pain after years of suffering. I highly recommend them.

  96. This is true. I realized this after going through the Courage Kenny Pain Management program. We tend to either ignore our pain, or struggle against it. Once you think of it as the brain's default interpretation of neural signals it can't otherwise identify, you can concentrate on getting to know your pain and redefining it to some extent: Ah, that's my feet talking to me. Oh, I've been ignoring my calf muscle and that's what it feels like Once you stop being angry at your body for the pain it is generating, and listen to it intently, the pain turns into something else, namely a conversation. Meditation helps.

  97. @Danny That strategy certainly changes the perception, but not the sensation.

  98. I don't know. I was driving down the road one day when all of a sudden this nearly debilitating pain occurred behind my right eyeball. My goodness, it was the most painful thing I've ever experienced. It came out of nowhere and it felt like someone was digging my eye out with a screwdriver. I came to learn that it was a cluster headache I got. I had never had one before and thankfully never since. If pain is an opinion, I had a pretty strong opinion that day and I don't think there's any way to change my mind about it.

  99. I'm a bit surprised by all the negative comments here. People seem to think the effects and intention of the article is to shame patients with pain. I would disagree. I learned from a life-changing injury many years ago that pain can be managed through managing your mental state. I think it's definitely both physical and psychological. I suggest people think outside of the box when it comes to dealing with pain, such as with meditation etc. It will not only help with pain management but make you a healthier person in general.

  100. @JayZSF But the sensation (the sensory experience we call pain) still "hurts".

  101. I’ve had some serious operations for cancer. I was given opioids to deal with the pain when I got home. Took them on the first day but they made me feel nauseous and dizzy—sick. I realized that I can’t make myself feel better if nauseous but I can use my brain to lessen the pain by distracting myself with reading, talking to a friend, watching a movie, listening to music, deep breathing. I’d much rather do that than take something that makes me sick to my stomach. I’ve also read an op-Ed in this paper written by someone living in Europe who had an operation and wasn’t proscribed pain relief meds. She was told that doctors in Europe think feeling some pain after a procedure is a good thing bc it makes you slow down enough to give your body the rest it needs to heal. Makes sense to me.

  102. Thanks to the author for his writings on pain. My misery loves company.

  103. This article seems to espouse two conflicting views regarding pain, which is confusing. View 1 is that "one thing we tend to believe about pain, but is wrong, is that it always stems from a single, fixable source". I assume "fixable" means truly isolable, rather than a problem that can be fixed, as with removing a tumor. I agree with this, but for the statement to be meaningful, the reader has to understand the implicit metaphysics, that what we consider to be one thing could be considered many, what we consider to be static is always changing. I believe this is true of everything, or at least everything in our experience, and doesn't only apply to pain. I think if this view is misunderstood, it can lead people to absurd views such as that removing a tumor will not remove the pain. (Though it is not true that removing a tumor will necessarily remove the pain - there is no necessary outcome, given complexity). View 1 is contradicted by View 2, that "In truth, pain is in our brain". There is no amount of explanation of the non-singular, non-fixable nature of the brain that can erase the radical dualism of this claim. Not only mind/body dualism, but brain/body dualism! As if sensation (ouch, or something momentarily pre-ouch) and judgment (I hate this sensation) involve two completely separate realms, rather than a complex, interrelated, open system. Also, the word "opinion" is too misleading, and should never have been used here, let alone emphasized as in the headline.

  104. @TMJ I entirely agree with your concluding sentence.

  105. I've noticed that medical professionals seem to regard pain as one more thing going on in the sensorium. Running enthusiasts who hold MDs sometimes have their toenails removed prophylactically to avoid pain over the long haul. Then there's the N.E. Patriot's kicker (Nick Folk) who went out and attempted a field goal days after emergency appendectomy. He's a pain professional too.

  106. My sister-in-law has been complaining of pain in her abdomen for 6 years - she has been to dozens of doctors and had 3 exploratory surgeries. No doctor can find anything wrong with her. As I sit here, she is searching for "better" doctors to do yet another surgery on her. What she refuses to acknowledge, and gets very defensive when it is suggested, is that she has severe anxiety and OCD. She refuses to even discuss going to therapy and won't even admit she has mental health issues. I believe that she believes her pain is real. I also believe her former doctors are all very qualified and she needs help. At the end of the day, I am frankly tired of hearing about her pain, which I am pretty sure is in her head. What is the harm in seeing a psychologist? If it doesn't work, she is no worse off, right?

  107. After being an MD for 43 yrs. Pain is real. Look for confirmatory imaging to document its presence. Treat with medication, devices, exercise and CBT. Don't think CBH will fix all. Too many non MD therapist are in on the therapy and have given up on treating patients.

  108. Have you read the stories of elite child gymnasts? They were and are told to ignore pain and compete regardless of sprains, fractures, pulled muscles, the flu, hunger pangs, you name it. Do you think they grow into into adults who are healthy in mind and body?

  109. I have compressed discs in my lower back. A couple times my legs could barely move. The nerves are literally pinched creating pain and limitations of motion. That definitely is NOT in my head. That's science.

  110. @Michael Fennelly my reading of the article, researchers would agree with you. Nobody here is saying that it is "in your head". How we experience pain, the way that it is transmitted, is in the brain. That is very different

  111. @mary therese lemanek sure, sure, and he can just will away the feeling of the nerves pinched by degenerative discs. if he just listens to music and breathes deep enough, his brain will stop the pain signals. i've heard pounding and works wonders too. get out all that suppressed emotions that are degenerating his vertebrae and pinching his nerves.

  112. @mary therese lemanek But pain is experienced in the body and not in the brain.

  113. Interesting timing on this article. I just had surgery to remove an elongated bone in my neck for the right side. I had the left side done 6 months ago. The “styloid process” on each side is normally .65cm. Mine were 4.5 and 5.5 cm each! The elongated bones press on nerves and the vascular system causing all kinds of nerve pain and issues. It took years to diagnose (Eagle Syndrome) then years to get a good head/neck surgeon to remove it. This pain existed for a reason. Now the errant bones are gone and I feel great.

  114. physical therapy can help with some pain--and deep breathing is part of that. But after major surgery, pain is NOT "all in your mind," and responsible use of medication under a doctor's care can help too. Incidentally, notable that playing wind instrument can involve deep breathing, and playing music demands mental attention so that can take our "mind" off pain for awhile. Also crafting, anything slightly physical. And in some instances, even watching DVDs with intriguing stories--helped my husband undergoing painfu; treatment for pre-cancer situation.

  115. How do you explain being asleep and then awakened by severe pain? That isn't a "choice" or....?

  116. People treating pain medicine addicts will tell you that many times, the pain it is a phantom. Basically, the brain says it likes the drug and if it has to fool you to get it, it will. Anecdotally, I have seen reports about self-medicating physicians in rehab who, after a couple of weeks of detox and therapy, wonderingly remarked, "But I WAS in pain, or so I thought. I'm a doctor. How could I have been wrong? But I was." Not to belittle true pain and it's causes, but there is always room for questions when it comes to pain.

  117. I hope someday you have the opportunity to feel some real pain that has a specific source. Then, you can go through all the alternatives to opiate therapy like people in real pain do. You will end up realizing that the only thing that alleviates pain reliably is the poppy. It doesn’t end the pain but knocks it down to a more tolerable level. Chronic pain patients are real and there are many of us.

  118. @Mike May I ask you three questions: (1) how can an experience (that is, "pain") also be a phantom? (2) Who is the brain talking to when it allegedly says "it likes the drug and if it has to fool you to get it, it will." (3) Is there a little person living in the brain who decides to fool the person who owns this anatomical organ?

  119. I was going to write a sarcastic comment about people who don't have chronic pain who give advice to people who DO have chronic pain but I decided not to. I'll just say: Be careful what you say to those of us who are in chronic pain. We are often touchy about it because we are usually very fatigued trying to do the things most people take for granted. Nuff said.

  120. @Sparta480 Well said!

  121. I had several life changing events & stressors that were followed by too many physical problems inc. daily headaches/migraines. I saw many Dr.'s & many specialists, spent $$$ for "outside the box treatments". Yes, I had imagining that could be easily read to show problems. However, as was explained by the Dr.s, just because I show X doesn't mean Y. I wasn't looking for drugs, I just wanted to not have pain run my life.I also wanted a definitive diagnosis so I could "solve" my problem. Finally I gave a low dose anti- depressant a try, was told (& read) the dose I was given was for migraines, a much larger dose is needed for mood. In a week my headaches were gone. I'd had earlier stomach problems and have heard headaches & stomach problems are connected. I've since read several books that promote essentially what the author is saying. There's a noted Back Dr. who says all back pain is suppressed emotion, & just recognizing that is enough to heal. I'm now trying harder to deal with my state of mind, than my physical aches & pains. Something else I think may be true for me, is that when I let my daily life be focused on my physical ailments, I have an excuse to not engage more fully in the real world.

  122. @JJ so you're addicted to an antidepressant and not an opiate. good for you. i'd like to see you try to stop taking that pill...

  123. @ceanf As would I, I take the lowest dose that leaves me relatively clear headed, yet with manageable headaches, after 3 years of daily. tension/migraines. Though I am still light & sound sensitive.

  124. Despite much lip-service to innovation and integration in providing treatment, US health is wildly un-integrated. It’s up to the patient to make sense of the menu of services, interactions and providers that any single health issue generates. You’re on your own.

  125. If Mr. Frakt and the researchers quoted in this article experienced the pain of, say, a herniated disk or a broken femur sticking out through the flesh of the leg, I suspect they would have a somewhat different view.

  126. Pain is relative--like almost everything else. Case in point, a study in which subjects were given enough codeine to numb the effect of measured amounts of painful stimulus. Same subjects were sleep deprived and the experiment repeated the next day--and they required more codeine in order to numb the same measured amount of pain. The study seems to suggest that when we are sleep deprived our natural endorphin receptors are less effective. Why? Maybe because sleep deprivation for cavemen equaled a dangerous situation--flood, famine, attack by an enemy group--and therefore the body dampens endorphin receptors to make the sleep deprived person in danger more vigilant. Pain is also an essential part of being a living animal. We experience pain because it helps us survive. Those without pain sensation can end up chewing off their own tongue in infancy as soon as they grow teeth. To paraphrase St. Francis, "Welcome, Sister Pain."

  127. As someone who has been identified as having 30 to 50% more pain receptors - biologically - than "normal" people I have to say that these assumptions don't validate the one truth all people share - my experience is mine. You have no idea how my body responds to sensory trauma, but I guarantee you, it is not like yours. Physiology can be very different from person to person, the effect of suffering, medical trauma or otherwise, is universal. And avoiding it is not a shameful thing.

  128. Pain is a term that is used broadly and experienced personally. In reading this article, my understanding is that you are sharing your approach to distracting yourself from pain, sharing the science behind distraction and the approaches used to distract patients as a method of pain management/ treatment to minimize reliance on pharmaceuticals. Thank you for sharing your experience with us. And, it may be worthwhile to update the article with the caveat that this article is applicable to pain that falls at the low end of the pain scale. Unfortunately, the generalization of pain simplifies the complex and feels to dismissive to those of us that suffer what we cannot control. Starting from the age of 11, I suffered severe, debilitating menstrual cramps that required prescription medication. At that age, it isn’t about stress or distraction - it is about dealing with the cruelty of biology. Now, I suffer from migraines. Again, excruciating pain that brings me to tears - meditation, music therapy and stress have nothing to do with the hormones that cause my migraines. I share this with you because you inadvertently did what so many of us pain sufferers experience- you dismissed us by minimizing the severity of our pain and burden. The challenging responses to this article are from people with chronic pain who hear this kind of messaging all the time and simply feel that heath care doesn’t listen to or care about them. Show us you are different.

  129. @Annie I came here to comment almost the exact same thing! Endometriosis is another example - a person often has no idea they have it, until the pain is so unbearable that they are in tears because nothing is helping. It is most certainly not in the mind, nor eased by cuddling from my partner.

  130. I highly recommend Feldenkrais practice which can be learned from a book and which I have found to be very effective in managing and reducing pain.

  131. I read the article with great interest. From my mid teens I suffered from colitis which caused extreme pain whenever I ate. My weight plummeted to 87 pounds and caused my failure in nursing school. During my first pregnancy i learned in my Lamaze class to reduce pain through visualization and relaxation. The colitis went away but I didn’t put that together with anything until I discovered when breastfeeding that the relaxation I used to feed my baby also relieved the colitis that had returned. Ah ha! Over the following years I learned the beta feedback was the only thing that could relieve the excruciating pain but that surprisingly I was often reluctant to use it. The pain was my comfort zone and my escape from stress.” Years later, after an almost complete remission of colitis, I suffered an herniated disc. I then learned that an Aleve and 30 minutes floating in my hot tub dialed down the pain, but walking was thereafter painful without constant stretching. Last summer everything changed. I spent 4 months in Paris and walked everywhere. My back pain was lessening due to the constant walking. But in 10 years I have not ever walked a half mile without pain. I then had an Ayurvedic massage and my pain is gone. Except one day when I was all stressed out about finding a means to print my documents to send my stuff home. The pain came roaring back. I found a printer and it left. Ah ha! That deep relaxation and deep calm was alleviating my pain. 3 months later it is stil gone!

  132. Very interesting article. A person’s capability to withstand pain varies from person to person. If a person is occupied in some way, pain doesn’t seem to bother that person that much. If that person does nothing but gets worried about pain, its effect appears to be magnified many times. One aspect that’s not mentioned here is pain associated with mental torture. A number of people have committed suicide on account of it whether due to all sorts of bullying or due to any other evil act.

  133. @Sivaram Pochiraju I agree that those who praise the article have not understood its potential devastating effect on those who are experiencing the "mental torture" to which you refer.

  134. Thankfully there are places like MGH pain clinic who do not think that "pain is an opinion."

  135. @nowadays Yes, when you come to react upon the headline of this article, the idea that experiencing pain is an opinion can be seen as nonsense.

  136. I once broke a femur completely in two in a ski jump that ended very badly. My leg flopped weirdly, clearly showing something was very wrong, but there was no pain at all. In the ski patrol shack, they asked if I'd like a shot of morphine. "Sure!" I said. I like to keep an open mind. It had no effect whatsoever that I could tell.

  137. Rubbish like this makes me think that much of medicine and even what we call science, is just theory, and is just as bogus as religion. Too bad so many helpless animals are tortured in cruel experiments by stupid humans, all of it in vain, because we are still completely ignorant of so many things, and torture and cruelty have not made us more intelligent or informed. I would bet that none of those suffering animals would think that their pain is all in their head.

  138. "One thing we tend to believe about pain, but is wrong, is that...pain is communicated from that source to our brains by “pain nerves.” That’s so wrong it’s called “the naïve view” by neuroscientists." Unfortunately that statement is inconsistent with what we know about neuroanatomy... https://www.ncbi.nlm.nih.gov/pubmed/9133176 ...and the provided link re "naive" is to a New Yorker article about the mysteries of itching, not an overturning of simple truths about the body.

  139. Mr. Frakt, I agree pain IS in the brain and we Can control it. Just read Dr. John E. Sarno's, M.D. books on back pain. Thank you, Karen Kohlmann

  140. In my practice I treat patients who suffer from facial pain. The challenge lies in the fact that not all facial pain occurs as a result of identifiable tissue injury due to a specific event or underlying medical problem. Some pain actually occurs when the nervous system itself is malfunctioning to an extent that the brain interprets normal information as noxious and therefore pain is reported. In these scenarios, pain perception and the response it provokes is the result of the brain rendering an opinion. Patients, once they understand that, are personally capable of influencing their pain and suffering.

  141. @Dr. Donald Tanenbaum And what happens if they cannot do so? Is it their fault?

  142. @John Quintner Hi John - to answer your question: pain is not their fault at all...there are times when the pain mechanisms are unresponsive to all efforts. It appears that the immune system, in collaboration with the nervous system, drives the suffering. Future pain medications will likely all be targeted to address the "upset" immune system as too many people are suffering in today’s world and alternative strategies need to be explored. Donald

  143. @Dr. Donald Tanenbaum The idea of a brain "rendering an opinion" is problematic. I hope you are not postulating the existence of a "little man" (homunculus) residing within the brain who decides whether or not the owner of the brain experiences pain.

  144. I learned this lesson well as a pediatric resident, in 1976. I spent a month as the sole acute care physician at the Wheat Ridge State Home, outside of Denver, in an era when thousands of people lived there. Many of those people had seizure disorders, and they would often fall and incur lacerations requiring stitches. It was my job to treat those lacerations. The first such patient I saw was a 22 year old with a big scalp laceration. He had significant intellectual delays, but was quite verbal. I asked the nurses for lidocaine so that I could give him a local before putting in the stitches, and they said he didn't need that. I argued with them for a bit, but they were adamant (they'd encountered this problem with all prior peds residents). So I asked him if he had had this all done before, and he said he had. I asked if he needed any medicine, and he didn't think he did. I told him I was going to sew up his head to make the bleeding stop and to tell me right away if I was hurting him. He promised he would. I proceeded to put in 12 stitches, and he didn't move a muscle or even wince. All pain is supertentorial. Just try to convince a "normal" person of that...

  145. I was comatose from a car accident in 2005. When I awoke I was in terrible pain for the first year. I think I was in so much pain, my brain couldn't handle it anymore and so for the next 7 years I lost the sensation of pain completely. I fell out of a moving car and laughed about it. I nearly chopped off the top half of my thumb and was cracking jokes as the doctor was stitching up my thumb. Finally, I fell down a flight of stairs and got up and kept walking as if nothing happened. I've learned how to control pain. It's a blessing.