Pain Isn’t What You Think: 4 Myths About Pain

Camilla Noble BScPT
Registered Physiotherapist
updated May 7, 2025

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Pain is something every human experiences, but few of us really understand it. If you’ve ever been frustrated, confused, or even dismissed when trying to make sense of your pain then keep reading.

The science of pain has changed dramatically over the past few decades, and many of the messages we still hear today are based on outdated models. In this article, we’ll explore four common myths about pain and uncover what the modern science tells us instead.

 

What is Pain?

The definition of pain according to the International Association for the Study of Pain Management is “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”

This definition highlights how pain is a unique and personal experience which is influenced by biological, psychological and social factors. In short, pain is a biopsychosocial experience.

Figure 1. The Biopsychosocial Model of Pain

Let’s debunk some common myths around pain to begin this journey to understanding pain better.

 

Myth 1: Pain Equals Damage

The Truth: Pain is not a direct measure of tissue damage.

This is one of the most common and misleading beliefs about pain. This belief originates from a historical model known as the Cartesian model, which  was developed in the 1600s by a philosopher named René Descartes.

This model suggested that if you feel pain, there must be damaged tissues in your body to explain the pain. This model taught that there is a 1:1 relationship between the amount of pain experienced and the tissue damage present in the body. This Cartesian model of pain taught that all pain experiences have a direct physiological cause which can be found in the tissues.

Although this model has played an important role in medicine, this simplistic understanding of pain is outdated and is unable to explain the cause of pain when pain lasts beyond the time of tissue healing or when medical interventions such as surgery or medications fail.

Modern neuroscience, however, has revolutionized how we understand pain. We now know that one can have significant tissue damage and feel little or no pain (as often happens in the immediate aftermath of a serious injury). Conversely, you can experience intense pain even when there is no clear evidence of tissue damage, such as in many chronic pain conditions.

Understanding this helps explain why scans or test results don’t always reflect how much pain a person is in—and why pain is always real, even when the cause isn’t visible on imaging.

 

Myth 2: Pain Lives in the Tissues

The Truth: Pain is produced by the brain based on perceived threat.

Our understanding of pain has come a long way since the cartesian model and biomedical models. Pain is both an emotional and sensory experience which is created as a response to threat in our body.

Let’s understand this with a simple example:

Have you ever kicked your toe on a day when you were stressed or just had a fight with a loved one? Compare this to kicking your toe on a day when you are out partying with friends? Which day does the pain feel worse even though the injury was the same?

I think we can agree that the pain is worse in the first scenario. This gives us a clue that the context around pain really matters- it influences the degree of how much pain we experience. This explains why the same injury can feel very different depending on the context. The injury is the same, but the brain’s interpretation is different.

There are no “pain receptors” in the body. What we have instead are nociceptors— these are specialized nerve endings that detect signals like pressure, temperature, or chemical changes. These nociceptors send signals to the spinal cord and brain, and then it’s the brain that decides when and how much pain to create.

Pain is a part of every-day lives of human experience and it works as a warning system. Your brain constantly interprets information from your body, your environment, your emotions, and your past experiences to determine whether something is a threat. If the brain believes something might harm you, it may create pain to protect you—even if there is no actual damage to the tissues.

 

Myth 3: It’s All in Your Head

The Truth: Pain is a multidimensional and whole-person experience, influenced by biological, psychological, and social factors.

When medical tests don’t provide clear answers, patients are sometimes told their pain is “all in their head.” This phrase can feel dismissive and hurtful—and it misses the point completely.

Pain is both sensory and emotional. It involves your nervous system, but also your mood, stress levels, beliefs, relationships, sleep, and more. This is known as the biopsychosocial model of pain, and it recognizes that all these factors interact to shape how we experience pain.

Far from being “just psychological,” the brain-body connection is real and powerful. Stress, anxiety, depression, and trauma can all amplify pain, just as supportive relationships, understanding, movement, and education can help reduce it.

 

Myth 4: You Just Have to Live With It

The Truth: There are many ways to influence and reduce pain—even if it’s chronic.

While pain can become persistent, it can be managed, reduced and understood better. We have seen in this blog how pain is multifactorial, which means there are many ways we can address these factors and improve a person’s pain.

Some of these treatments supported by evidence in modern pain science open up a myriad of treatment options beyond medication and surgery, including:

• Gentle movement and exercise
• Education about how pain works
• Mind-body approaches (like mindfulness or relaxation techniques)
• Physiotherapy
• Cognitive behavioural therapy (CBT) or other psychological support
• Sleep and stress management

Figure 2.  Pain as a volume dial

Think of the brain like a volume dial. If the brain senses threat, it may “turn up the volume” on pain. But if it feels safe, supported, and informed, it can “turn down the volume.”

Think of these treatments as options for turning the volume dial down on pain- we need to help the brain and body feel safe again and finding ways to turn the volume down.

 

What This Means for You

If you’re living with pain, I want you to know that your pain is valid and real even if you’ve been dismissed by health care professionals because your tests don’t show a clear cause.

Modern pain science shows us that pain is changeable, thus with the right support and understanding,  people have found they can reduce their pain and improve their quality of life. The first step is learning more about pain and what treatment options are available to you. By reading this blog, you’ve done already started this process.

In future articles, we’ll look more closely at the difference between acute and chronic pain, and explore practical strategies to help manage and treat pain in a way that supports your whole self.

 

Do you want to dive deeper?

Watch this video

Watch this short explainer video from Professor Lorimer Moseley, a world leader in pain science: Why Things Hurt

Read these informative blogs:

https://mycuppajo.substack.com/

https://restoringvenus.com/blog/

 

 

References:

Adams, L. M., & Turk, D. C. (2018). Central sensitization and the biopsychosocial approach to understanding pain. Journal of Applied Biobehavioral Research, 23(2), e12125. https://doi.org/10.1111/jabr.12125

Louw, A., Schuemann, T., Zimney, K., & Puentedura, E. J. (2023). Pain neuroscience education for acute pain. International Journal of Sports Physical Therapy, 18(2), 345–353. https://doi.org/10.26603/001c.118179

Moseley, G. L. (2013). Reconceptualising pain according to modern pain science. Physical Therapy Reviews, 12(3), 169-178. https://doi.org/10.1179/108331907×223010

Moseley, G.L (2003). Unraveling the barriers to reconceptualization of the problem in chronic pain: the actual and perceived ability of patients and health professionals to understand the neurophysiology. https://doi.org/10.1016/S1526-5900(03)00488-7