Writing an article about pain in my profession may seem logical enough.
The title of this text, however… maybe not so much.
I've been thinking about writing this ever since I started working with patients – with their pain and, more importantly, with their stories. And sadly, these stories are often not about finding help, but about how difficult it is to get it.
In my own little encyclopaedia of life – in my head – not acknowledging someone's pain, ignoring it or belittling it, is written under the word crime.
Because isn't it true that when we're in pain, we are at our most vulnerable? We reach out for help, we open up, and we entrust someone with our well-being. So, how else can we describe it if that pain is not taken seriously?
Just last week, a new patient with chronic pain spent long minutes telling me how many times she had been told, "Many people live with this, just take painkillers and wait until it passes".
And then there's the classic: "I've simply learned to live with pain".
A classic that should be rare, exceptional, one in a million — not an everyday reality.
And that’s precisely why it's so important to talk about pain. To talk about it differently.
Looking at pain differently
The International Association for the Study of Pain (2020) defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage".
Unpleasant sensory? Clear.
Emotional experience? Not always as obvious — but it should be.
And perhaps the most essential part: actual or potential tissue damage.
This tells us something crucial: pain is always real, but it is not always simple.
Three different types of pain
Scientists usually describe three main types of pain:
• Nociceptive pain – the body's "normal alarm system", caused by actual tissue injury such as a sprained ankle or a cut.
• Neuropathic pain – pain caused by irritation or damage to the nerves themselves, such as sciatica.
• Nociplastic pain – a newer category, where the nervous system becomes more sensitive and pain is present even without clear tissue or nerve damage. Researchers believe this may explain conditions like fibromyalgia, tension-type headaches or irritable bowel syndrome.
All of these are real pain. What differs is what drives the experience.
Pain ≠ damage
Modern pain science shows us that pain is not a direct measure of tissue damage, but an experience generated by the nervous system — brain, spinal cord and nerves together — as a protective response. Sometimes the alarm is accurate, sometimes it rings long after the fire has gone out.
👉 And just to be clear: this never means that pain is imagined or "all in your head". Pain is always real. What it does mean is that your nervous system can sometimes stay protective for longer than your tissues actually need — and that explains why pain can feel overwhelming even when scans or tests come back "normal".
One way to think about it is like a smoke alarm that keeps going off when you make toast — it's doing its job too well, even though there is no fire.
This is why David Butler and Lorimer Moseley often remind us: "Hurt does not always mean harm".
We even see this in research: many people show "degenerative changes" on scans without any pain at all, while others experience ongoing pain despite clear healing in their tissues. Both are real, valid experiences.
Chronic pain and why it matters
This is especially important when we talk about chronic pain.
NICE guidelines (2021) highlight that chronic pain is common, but it should never be dismissed as "nothing to do but take pills."
Instead, best practice is holistic: combining education, physical activity, lifestyle strategies and psychological support. Pain should never be reduced to "take some tablets and wait".
My take as a therapist
For me, this means that listening, validating, and understanding are not "extras" — they are as important as any treatment technique.
Because when people feel believed, they can begin to rebuild trust in their bodies and discover new ways forward.
So what can help?
If pain is always real — but not always simple — what can we actually do about it?
Research and guidelines suggest a few essential steps:
Seek support.
Every pain deserves attention. Checking it with a professional is not about being dramatic — it's about understanding together where it comes from and what can help.
Stay active in safe ways.
Gentle movement, such as walking, stretching, or exercise you enjoy, can help keep your nervous system and body calmer.
Look after the basics.
Sleep, pacing your energy, and small stress-relieving habits (like breathing or relaxation) all influence pain sensitivity.
Understand your pain.
Sometimes, just knowing that pain ≠ does not equal damage reduces fear and helps the body settle.
None of these are "quick fixes", but together they can change how pain feels and how much it controls your life.
In the end
Pain is complex. It's not only about tissues, but about protection, perception, and the whole person.
And while it can feel overwhelming, it is also something we can understand and work with. Nobody should ever be left alone with their pain — because being heard and understood is often the first step towards feeling better.
And if you ever feel you need extra support, I'm here — ready to listen, to work with you, and to help you move with less pain.
💬 I'd love to hear your thoughts — whether it's a comment, a question, or even your own story. Feel free to share below.
Warm regards,
Magda
Sources and further reading
Brinjikji W, Luetmer PH, Comstock B, et al. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol, 36(4):811–816.
Moseley GL, Butler DS. (2015). Fifteen years of explaining pain: The past, present, and future. The Journal of Pain, 16(9), 807–813. https://doi.org/10.1016/j.jpain.2015.05.005
Raja SN, Carr DB, Cohen M, et al. (2020). The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain, 161(9):1976–1982. Available at: https://pubmed.ncbi.nlm.nih.gov/32694387
🙌