You're doing your favourite sport, and you're totally absorbed in it. Suddenly you hit your knee. You hardly notice it, because you have to and will go further. And you go further, finish what you started and get a good result. After a while you hardly notice that you had bumped your knee. 

Now imagine the following situation. You are at home and don't have much to do. You want to take something out of the fridge, and on the way you bump your knee. You curse the table you bumped into and notice that you are suffering. You just sit down on the couch with a stretched out leg and get sick. 

What's the difference?

If we assume that in both cases the knee was hurt just as hard, you can imagine that the feeling of pain both times is quite different. If, in both cases, an interviewer had asked the question 'How much pain do you experience on a scale of 0 to 10?' shortly after the injury, it probably would have looked like this:

Situation 1: 'Yes, sorry, I don't have time for that now, it's not that bad. Huh... a 2, or so'.

Situation 2: 'Pffff, ouch ouch... Yes, I did hit my knee hard. Wait, I need to sit down now. This is an 8!'

It is a good example of the 'subjectivity' of pain. Which means that the amount of pain only partly depends on the extent to which someone suffers damage to his body. 

You could even say that the damage done to the body does not even determine for the most part how much pain the brain produces! 

What influences the pain you feel?

We now know from many other things that they influence the perception of pain much more than the actual 'stimuli' that travel through your nervous system. 

Attention: The more attention for the danger, the more room the brain has to create pain. As in the example above: if the attention is somewhere else, a person quickly feels less pain. If you are in pain, it helps a lot to focus your attention on something else!

How you feel: Stress and other negative feelings cause your pain system to perceive danger more quickly and create more pain. Tension can also cause you to tighten your muscles (too) much unconsciously, which can increase pain symptoms. It is therefore especially helpful to undertake positive or relaxed activities.

What you're thinking: Beliefs about pain play an important role in the amount of pain experienced. All thoughts that confirm 'DANGER' increase the chance that your brain will create more pain. Thinking about the negative consequences in particular results in many disadvantages. Also because it causes negative feelings. Reading about pain and how pain really works is a proven effective way to positively influence thoughts about pain! 

What you do: Finally, 'what you do when you are in pain' makes the most difference. Especially if you succeed in changing your behaviour in such a way that your attention is no longer focused on the pain, you have fun and have no room to think about negative thoughts. Often it works best if you are not happy with a hobby, or if you even succeed in a physical or social activity that gives you pleasure.

Same experience, different outcome

The same stimuli can, depending on how you deal with this, lead to completely different pain experiences. This also explains why people with the same physical problems never report the same pain. In fact, a researcher has never been able to demonstrate the connection between certain physical problems and pain! 

The great thing is, there is a lot of room here to improve your own situation. Everyone can make progress with his or her pain symptoms, no matter what cause or diagnosis is behind them. Because we can all influence our own attention, behaviour, feelings and thoughts.