Cynthia Thomson, PhD, Pain Researcher
September is Pain Awareness Month: What Everyone Should Know
Did you know that 1 in 5 Canadians live with persistent pain? Pain is the top reason why people seek medical care, and it accounts for approximately one-third of the patient load for family physicians.
The effects of pain go beyond physical discomfort. Pain can affect our work, relationships, mood, and nearly every part of daily life. Yet despite how common and burdensome it is, most people do not have a basic understanding of how pain works.
Rethinking How We Understand Pain
In 2020, the International Association for the Study of Pain (IASP) updated the official clinical definition of pain to:
“an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”.
The nuanced changes in the definition are important because they reflect the complexity of chronic pain. Embedded within the definition is the fact that pain is not an accurate reflection of tissue damage. All pain is perceived in the brain. Most importantly, pain is influenced by many factors: our thoughts, emotions, past experiences, and the context of the situation. This complex interplay is known as the biopsychosocial model of pain.
Examples that show the brain’s role and the importance of context
- Under general anesthesia: Surgeons make incisions and cause trauma to tissue, yet the patient feels no pain. Danger signals are sent from the body, but the brain does not perceive them. The result: no pain.
- During distraction or duress: In high-stakes sport or a traumatic event, people sometimes do not feel pain until later, once the stressor is removed. The brain’s attention was elsewhere. The result: no pain.
- Social cues matter: A child scrapes a knee and does not react until a parent gasps. The child senses worry and fear, and then the tears begin.
The public’s understanding of chronic pain does not align with the evidence
The clinical definition of pain is not widely known. Many people still believe that pain equals harm. It is important to emphasize: pain does not equal tissue damage. Rather, pain aims to protect us, but sometimes it is an overzealous protector.
Below are statements adapted from a validated tool that measures knowledge about pain. Try to decide whether each is true or false.
True or False?
- It is possible to have pain and not know about it.
- Chronic pain means that an injury has not healed properly.
- The body tells the brain when it is in pain.
- The brain decides when you will experience pain.
Answer Key
- False
- False
- False
- True
Of these statements, only the last one is true: the brain decides when you will experience pain.
Pain Awareness Matters
There have been ongoing calls for improved public awareness about how pain works. In 2021, experts in the United States cited a critical need for a national public education campaign about pain. Pain scientists in Australia have expressed similar needs. Learning about pain, often called Pain Science Education, is an effective first-line treatment for many pain conditions.
UFV “Let’s Talk about Pain” Study Series
We have been exploring ways to talk about pain with people living with pain. We asked: how do we best share the knowledge that pain is a multifactorial experience? This can be a difficult topic for health care providers to broach because it challenges beliefs and can be misinterpreted. Pain is in your brain, but that does not mean it is “in your head”.
Through focus groups, participants reported that learning about the brain’s role in pain gave them hope, a sense of agency, and motivation to try new self-management practices to change their pain. Most of our sample had low baseline knowledge about how pain works, scoring under 40 percent accuracy on a pain knowledge tool, and most had never been told by their health care providers that pain is the product of a complex interplay of many factors.
More recently, we asked the same question of health care professionals. Informed by findings from two recent studies, we plan to co-develop tools that support a patient-centred introduction to the multifactorial model of pain in clinical settings.
Improving knowledge about pain can lead people living with pain to a wealth of freely available online resources to learn how pain works, retrain their brain, and move safely through pain.
We are recruiting participants
We are recruiting for a study that employs mind-body techniques for the treatment of chronic pain. In this student-directed study, Courtney Snell, a 4th year UFV Kinesiology student, is investigating a dual intervention that combines psychological modalities through engagement with a mobile app with a virtual asynchronous gentle movement program. The 6-week intervention is designed to be carried out remotely to reduce barriers to participation.
Recruitment closes September 30, 2025. If you are interested in learning more, please see the study poster below.
Knowledge is Power: Pain Resources
- Flippin’ Pain
- Pain Revolution
- Understanding pain in less than 5 minutes (video)
- Tame the Beast (video and resources)