Persistent pain: Is it all in your head?
What Causes You to Feel Persistent Pain?
When you injure yourself, specialised pain receptors located at the ends of your nerves detect this injury and send signals through the spinal cord to your brain. Your brain then interprets these signals as pain. This mechanism serves an important survival purpose, alerting you to tissue damage so you can protect the injured area.
However, persistent pain (also called chronic pain) is pain that lasts beyond the normal healing time of about three months or continues even after physical injury has healed. In these cases, your pain receptors might not be receiving strong signals from injured tissues, but your spinal cord and brain continue to send intense pain signals. This process, known as central sensitisation, causes the brain to amplify pain sensations even when no tissue damage is evident on scans. This explains why some people feel severe pain from seemingly minor stimuli, such as gentle touch.
Persistent pain is not just a physical experience, it is deeply connected to emotional and psychological factors. The brain regions responsible for processing pain overlap with those that manage emotions, such as anxiety and stress. Emotional distress can worsen pain by increasing muscle tension and activating shared neurobiological pathways. This mind-body connection is why psychological support is a crucial part of effective pain management.
So yes, persistent pain is “in your head,” meaning it is processed by your brain and spinal cord. But this does not mean your pain is any less real. Understanding this mind-body connection is key to effective treatment and improving quality of life for those experiencing chronic pain.
We highly recommend watching this talk by Lorimer Moseley on Why Things Hurt for a more detailed explanation.
So what can you do about persistent pain?
How Can You Manage Persistent Pain?
As leading pain researcher Professor Lorimer Moseley explains, pain is not a direct measure of tissue damage, it is the brain’s interpretation of threat. In cases of persistent pain, the nervous system can become overprotective, continuing to signal pain even when there’s no ongoing injury. This means that pain is very real, even if it no longer reflects damage to the body.
This is where psychological support for chronic pain can be helpful. A pain management psychologist can help you understand how your brain processes pain, especially when emotional factors like fear, anxiety, or past trauma are involved. Therapy aims to rewire pain pathways by addressing unhelpful thought patterns, reducing fear-avoidance behaviours, and building more adaptive coping strategies.
This approach doesn't mean the pain is “all in your head”, rather, it acknowledges the mind-body connection and works with the brain’s role in pain perception to support long-term recovery.
If you’re interested in incorporating psychological support into your pain management plan, please feel free to Contact Us or Book an Appointment.