Haims: New research is changing how we address pain
There is no such thing as a “pain receptor” in our body. Pain is produced within our brain and it is our brain that determines our pain threshold and experience. Fortunately, we have the ability to retrain our brain how to interpret pain.
We can retrain our brain to control pain and, by changing our understanding of pain, we can better manage it. Pain is nothing more than information. Unfortunately, we have been taught that pain is a bad thing — something to avoid and to be feared. However, consider an athlete’s relationship with pain. Athletes break through various thresholds of pain during training and thus systematically improve their abilities.
We too can improve our abilities. We just need to rethink what we know about pain. Over the next few columns, I will provide information from people who specialize in the study of pain.
This is the first installment in a series of columns addressing pain. While advancements in modern medicine have been miraculous over the past 50 years, our understanding of pain is not fully understood.
The following series of interviews with Dr. Elie Sabins, a physical therapist and therapeutic pain specialist at Howard Head Sports Medicine, will be transformative.

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What is different about our understanding of pain than that of years ago?
We used to think that when you got hurt, special pain receptors would send messages up to your brain to let you know that you were in pain. However, we now know that rather than having pain receptors that transmit pain, we actually have “danger” receptors that are alerted when there are potential threats around us. But it is up to our brain to decide if these signals are ones it needs to alert us about or not … like if you had your hand on a hot burner (trust me, you’d want to know about that).
If you need more convincing, consider your vision. We can all agree that we use our eyes for sight, but our brains decide what we really see. Look at this picture:

At first glance, you might see a duck. Or, you might see a rabbit. The answer is that it can be either of these animals — based on what your brain sees. Another great example is the gold dress or blue dress question that was an internet sensation a few years ago.
These are great examples of how receptors in our body give us information, but it is up to our brain to decide how to interpret them. Is it a rabbit or a duck? Is the dress gold or is it blue? Or in other words, is this worthy of creating pain to get your attention or not? Just as we can see multiple animals or think the dress is a different color, we can all have different perceptions when it comes to pain.
How is new research changing the way we think about pain?
Now that MRI technology has been around for about 30 years, we have started imaging studies on people with pain and also people without pain, and the findings have been fascinating. We now know that about 40% of people have “bulging” discs without any pain, 1/3rd of people over 30 have abnormal findings on their shoulder scans who have no knowledge of this, and even one in three collegiate basketball players have significant findings on their knee MRIs – yet they have no pain and are playing high level sports every day.
These studies show us that if pain lives solely in our bodies, every single person in these studies would be experiencing pain. I think that this is such a message of hope: Even if you have been told you have “abnormal” findings on your X-rays or MRIs, it doesn’t mean you have to live with pain. There is way more to the picture.
Now you may be wondering, how is this possible? Or maybe you are thinking, what can I do for my knee, shoulder, back, ankle, neck, etc. that has been bothering me for weeks, months, or years?
A good way to understand these complex topics is to think of there being a “pain dial” in your brain. There are a lot of factors that can turn up your pain dial to magnify your pain experience, but there are also a lot of things that can turn your dial down as well. And now that we’ve got you hanging onto our every word, you’ll have to stay tuned for the next column to learn more about what these things are.
For the past couple of months, Judson Haims, the owner of Visiting Angels, has sat with physical therapists Doug Emerson and Elie Sabins to learn about how new pain research is being integrated into the physical therapy practices at Howard Head Sports Medicine.