Understanding pain. Let's start with the brain.

The first thing that everyone has to face is that all pain is in the brain.  The pain is not in your back, thumb, neck, shoulder, elbow  - or whatever.  The pain is in your brain.

Your brain creates it.  

You don't see with your eyes.  You don't hear with your ears.  You don't taste with your tongue.  You don't smell with your nose.  And you don't feel with your body.  All of these sensory experiences are a product of the brain.

Of course, the brain creates these experiences based on information it gets from your eyes, ears, tongue, nose and body - but the experience is a brain experience.

I have chosen to use the word "brain" and not "mind" for a very specific reason.  It would not be true to say that "all pain is in the mind", for this would imply that pain is a purely psychological phenomenon.  It is true, however, to say that "all pain is in the brain", because until we become aware of pain, it is not called pain; and awareness is a cortical function - a function of the brain.

When I explain this to patients, I also have to acknowledge that from their perspective, they are indeed "feeling" the pain in their body, just as they are "seeing with their eyes".  It seems too academic to say that "the pain that you're feeling in your back, is not in your back".  For the patient, the pain is where they say it is, and for the most part they just want it gone.  

This is a fair objective - to want the pain gone.  But to begin to develop a consistent approach to solving patients' pain problems, one has to understand pain.  And to understand pain means that you have to understand that pain is in the brain.