Understanding Pain: More Than Just a Feeling

For many of the world's millions, pain is not an occasional inconvenience—it's a daily sidekick. From pounding headaches and arthritis pain to slicing nerve pain, much of the world lives with pain every day. While we all experience pain, we do not all experience it the same.

Pain is highly individualized. Others may wince at the slightest bump, whereas others don't even flinch from a rough tumble. It has nothing to do with weakness or strength—nor science. Pain is more than just a bodily sensation, according to Professor Bart Morlion, an international expert in pain medicine at KU Leuven Cancer Institute in Belgium. Speaking in Nairobi last week when inaugurating the Haleon Pain Management Institute, Prof Morlion observed that pain is a biopsychosocial phenomenon—not only our bodies, but also our mood, mindset, and environment.

"We don't yet have tools to measure pain objectively. We rely on patients to report to us how they feel—from 0 to 10," he said.

While subjective, that pain scale remains the gold standard in practice. It is also a reminder that no two people experience pain in exactly the same way.

Why Do Some People Tolerate Pain Better?

While our pain threshold—when we begin to experience pain—is quite consistent in individuals, pain tolerance varies greatly. Attitude, psychological resilience, life history, and even cultural heritage are all conditions that decide how much pain we can withstand.

This delicate dance between body and brain also explains why two individuals with the same injury will rate pain by orders of magnitude differently.

How Painkillers Actually Work

We all grab for painkillers when we hurt. But what exactly happens when you pop a pill?

Different drugs affect different parts of the pain process:

• Paracetamol reduces the brain's feeling of pain.
• NSAIDs (e.g., ibuprofen or diclofenac) cut down inflammation, a cause of pain.
• Opioids (e.g., morphine) switch on the brain's own pain-killing systems.

Briefly, some drugs turn off the pain signal, others block out pain, and others do both. But, as beneficial as they are, these drugs are not without danger.

Paracetamol is generally safe—but high doses damage the liver.

NSAIDs lead to stomach ulcers, kidney problems, and increased heart risk, especially among older individuals.

Opioids, though powerful, carry a risk of dependence—even for those who have totally no history of addiction. "There is a risk of around 8% that patients may become dependent, perhaps within as few as a few weeks," cautions Prof Morlion.

Acute pain serves a purpose—it warns us that something's wrong. But when pain persists after the healing of the initial injury, it becomes chronic. This can occur if the nervous system becomes hypersensitive, a situation known as central sensitization. Pain is then the disease itself.

Sudden withdrawal from pain medication also produces rebound pain, an intensified return of symptoms, especially common with the use of NSAIDs in diseases such as arthritis.

And some pain syndromes, like fibromyalgia, are unseen but hellish. Without overt harm or inflammation, patients hurt all over and are tender to the touch due to an oversensitive nervous system. It is a disorder that disproportionately afflicts women and is commonly misdiagnosed or dismissed. 

The Mind-Body Connection

While medication is a key component, psychological techniques could also influence the way we feel pain. Techniques such as breathing exercises, guided meditation, and distraction strategies can all be employed to instruct the brain to dial down its pain response.

"The brain is a very powerful tool," Prof Morlion says. "With the right methods, we can instruct it to register less pain."

This's not about denying pain or "toughing it out" but about utilizing all available approaches, from medication to mindfulness, to maximize quality of life.

Pain Isn't Just a Symptom—It's an Experience

Reminding us of something important, Prof Morlion says, "Pain is more than just a symptom. It's an experience that affects your body, mind, and quality of life."

By embracing a biopsychosocial model of care, healthcare providers can move beyond just treating symptoms. They can help people truly heal—body and mind.

If you’re living with pain, know this: you’re not alone, and help is evolving. The future of pain care lies not just in pills, but in compassion, understanding, and a full-spectrum approach that puts patients first.