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Must an injury always hurt?

Episode
3 of 16
Published
Feb 7th, 2018
Run Time
21m 58s
Topic
A practical guide to persistent pain therapy
Your Instructor
Mike Stewart
Mike Stewart
Mike is a physiotherapist and visiting university lecturer with twenty years of experience managing complex, p...

Episode Summary

Pain isn’t a simple signal from injured tissues—it’s the brain’s interpretation of many competing messages. Through striking real-life examples and practical clinical insights, learners discover why injury and pain don’t always match, and how better communication can transform understanding.

Pain is presented as an interpreted experience rather than a direct signal from injured tissues. The teaching begins by separating three ideas that are often confused: injury as a tissue event, nociception as subconscious neural warning activity, and pain as the brain’s interpretation of many signals. Learners are shown that pain and injury do not always match: severe injuries may produce little or delayed pain, while minor problems such as paper cuts or migraines can be intensely painful. Several unusual examples are used to build curiosity, including a man who did not notice a knife in his skull at first, athletes performing despite major injuries, and a runner who only felt foot pain after a race ended. These cases illustrate how context, attention, threat, and social factors shape pain. The transcript also explores persistent pain, explaining that tissues may heal while pain continues because the problem is no longer purely somatic. In clinical practice, it emphasizes empathy, communication, facilitation, compassion, and big-picture biopsychosocial thinking. Learners can expect a strong challenge to simplistic “pain equals damage” beliefs and practical guidance for helping patients make sense of pain.
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Roleplay 2 - Are you saying it is in my head?

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