The Brain’s Role in Pain Signals

 

Pain is never “just in your head” - but it is always, in part, processed by your brain. Pain is the brain’s protective alarm system, built to keep you safe. The problem is that sometimes the alarm can become overprotective: it keeps ringing even after tissues have healed, or it turns the volume way up in response to stress, poor sleep, inflammation, or repeated injury. Understanding how the nervous system works can be deeply reassuring, because it explains why pain can linger - and it also opens more doors for relief.

Pain Is A Warning System, Not A Damage Meter

The nerves in your body send information to your spinal cord and brain about pressure, temperature, inflammation, and potential threat. Your brain then decides how much protection is needed, based on context: past experiences, current stress levels, sleep quality, mood, beliefs about the pain, and what else is going on in your life. That is why two people can have similar injuries and experience very different pain.

How Pain Can “Turn Up”: Central Sensitisation

One important concept in persistent pain is central sensitisation. This is when the central nervous system becomes more responsive - like a car alarm that goes off when a leaf falls on it. In central sensitisation:

• normal sensations can feel painful (allodynia)
• painful sensations can feel more intense (hyperalgesia)
• pain can spread or linger longer than expected

This does not mean the pain is imagined. It means the nervous system has become excellent at producing pain - even when the original danger signal is smaller.

The Pain Networks

Modern neuroscience describes pain as a network experience. There are areas involved in the sensory side (where is it? how strong is it?) and areas involved in meaning and emotion (how threatening is it? what does it mean for me?). This is why fear, trauma, or ongoing stress can intensify pain, and why feeling safe and supported can soften it.

Your Brain Also Has Built-In Pain Relief Pathways

You have natural “down-regulation” systems - descending pathways that can dampen pain signals. These pathways are influenced by sleep, movement, mood, social connection, and the sense of control. When these supports are missing (for example during burnout, anxiety, isolation, or insomnia), pain often feels louder.

What Helps Calm an Overprotective Nervous System

Persistent pain usually responds best to a layered approach - not one magic fix.

1) Gentle movement that rebuilds trust

Movement is not just about muscles; it sends safety signals to the nervous system. The goal is graded activity - starting small, pacing carefully, and building gradually so the brain learns: “We can do this safely.”

2) Sleep support

Poor sleep increases pain sensitivity and reduces the nervous system’s ability to regulate itself. Improving sleep routines, timing, and bedtime wind-down can have a meaningful impact on pain intensity.

3) Stress regulation (because stress and pain share pathways)

Breathing practices, mindfulness, relaxation, and simple nervous system calming techniques can reduce the “threat load” the brain is carrying. This doesn’t erase pain overnight - but it often lowers the baseline intensity over time.

4) Addressing the drivers

Sometimes pain persists because there are ongoing drivers: untreated inflammation, nerve irritation, medication side effects, low mood, hormonal changes, or other medical conditions. This is why assessment matters - you deserve a plan that fits your pattern, not a generic checklist.

When To Get Assessed Urgently

Pain should always be assessed promptly if it is associated with red flags such as chest pain, sudden weakness/numbness, loss of bladder/bowel control, unexplained weight loss, fever, or severe night pain - or if something about it feels significantly different to your usual.

Closing Thoughts

Pain is real. And when pain becomes persistent, it often means the nervous system is stuck in “high alert”. The hopeful part is that nervous systems can change - they can become calmer and less reactive - especially when you combine medical assessment with steady, supportive strategies.

Sources 

• IASP - Central sensitisation overview and pain education resources. (IASP)
• Curatolo et al. (2023) - Central sensitisation: pathophysiologic and clinical relevance (review). (PMC)
• Cleveland Clinic Journal of Medicine (2023) - Central sensitisation, chronic pain and related symptoms. (CCJM)
• NHS Inform - Chronic pain and nervous system/brain changes (patient guidance). (NHS Inform)