Sensible advice for aches, pains & injuries


Myths and Misconceptions about Explaining Pain 

Paul Ingraham ARCHIVEDMicroblog posts are archived and rarely updated. In contrast, most long-form articles on are updated regularly over the years.

Many moons ago I started trying to understand and explain pain, gradually producing an article: Pain is Weird.

I was only dimly aware as I worked that I was re-producing some much more mature ideas. I knew that modern pain science and treatment has deep roots, insights and research going back to the 1960s and Melzack, gate control theory and cognitive behavioural therapy, but my explaining was eerily similar to a recent and popular “packaging” of pain science known as Explain Pain (EP), from Drs. Lorimer Moseley and David Butler: “a range of educational interventions that aim to change one’s understanding of the biological processes that are thought to underpin pain as a mechanism to reduce pain itself” (Moseley). There’s a book of that name — Explain Pain — and many other interpretions and riffs on the key ideas (like my own). It’s not that I invented my own version of Explain Pain independently, I was just trying to explain pain, you know? Lowercase!

Explaining Pain according to Dr. Moseley is about “wanting people to actually understand how and why they can be in horrible pain yet not in horrible danger.” According to me, explaining pain (might) help to reduce it, and it’s inherently fascinating even if it doesn’t do a lick of good.

There have also been a lot of misunderstandings. Because explaining pain is tricky. (There are still plenty of unanswered scientific questions, too.) And because Explain Pain as a “brand” might be a little bit of an over-hyped upstart, maybe given too much credit by too many people too soon — especially the idea that it actually reduces pain, which remains highly speculative. Nevertheless, for the record, here are some key misconceptions about EP…

But the mother of all misunderstandings is the popular idea that if pain is an output of the brain, then we must be able to think our way out of it. It’s such an important and difficult topic that most of the rest of the article is devoted to it.

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