Chronic Pain. Fibromyalgia. Arthritis. So many have to deal with the accusation that it is “all in your head.” Even if said with the best intentions, this statement is gaslighting at it’s finest. It is telling those with pain, that what they feel and experience isn’t real. Which, of course, we know it is.
What does “all in your head” even mean? That phrase is usually slung to imply that there is some psychiatric reason for the pain. That somehow the person (usually a woman) is “crazy.” Sadly, this phrase isn’t always just from our friends or family, but also from those we go to for help, our healthcare providers. The intent may not be to belittle or push aside but it hurts nonetheless. In our hurried medical world, it isn’t just easier for the patient to take a pill for all their ailments, but it’s easier for the doctor. When given 10-20 minutes, there is hardly enough time for anything besides writing a prescription. When thinking about the science of chronic pain, I keep coming back to one conclusion…it IS all in our head. Because our brain is in our head! Oversimplifying? Yes. But still helpful. Learn more about how science tells us the nervous system is implicated in chronic pain: keep reading or watch the video above
The research behind chronic pain is exploding and has expanded our knowledge, not just in chronic pain syndromes such as fibromyalgia, but also in migraines, autoimmune conditions and degenerative conditions. It is complex and most likely involves many different systems, including hormonal, immune and psychiatric. BUT one thing seems certain. Our central nervous system is, well, central to it all. How we perceive pain is very real because it is rooted in how our nerves speak to each other. Our system is set up to warn us of danger and protect us from overwhelming painful stimulus. But in chronic pain that system is out of balance.
Our nervous system is made up of signals that warn the brain of pain and signals that dampen that message. We are wired to survive, so being able to detect danger and feel pain is imperative, however in fibromyalgia and other chronic pain syndromes, those pain signals are “wound up” and are stronger than they otherwise would be. To make matters worse, the normal dampening signals from the brain, that protect us from getting overwhelmed with pain in times of severe injury, are dysfunctioning and don’t do as good a job stopping the pain signal from reaching the brain.
When two people (one with chronic pain, one without) are exposed to the same, non-painful stimulus, there are actually differences we can see in their brains using functional MRIs. So you see….yes, it IS in your head! The medications tested and shown to be effective are medications that work on the nervous system. Yes, they are imperfect and yes, we have a long way to go in fully understanding the complex interplay between our brain, our hormones, our immune system, our gut and our mind. But next time someone politely suggests your pain is “all in your head” simply reply, “yes, I know” and move on.
In good health,