5 Surprising Truths About Pain That Could Change How You Heal

Introduction: The Story We Tell Ourselves About Pain

Living with persistent pain can be deeply frustrating. It’s easy to fall into the trap of thinking your body is broken, that a part of you is worn out and will never be the same. This narrative of damage can feel overwhelming, leaving you feeling like a victim of your own biology. But what if that story isn't the whole truth?

Modern pain science offers a different, more hopeful perspective. It reframes our understanding of pain, moving away from a simple model of tissue damage and toward a more dynamic story of adaptation, protection, and learning. This new narrative doesn't dismiss what you feel; instead, it empowers you by explaining the complex processes behind it.

This article shares five of the most impactful and counter-intuitive truths from recent discussions in pain science. These ideas can fundamentally change how you think about your body and its capacity to heal, giving you a more active role on your recovery journey.

1. Pain Isn't a 'Thing' in Your Tissues—It's a Process You Can Influence

We often talk about pain as if it's a concrete entity—a "thing" located in a specific joint or muscle. But as pain scientist David Butler explains, it's far more accurate and helpful to understand pain as a dynamic process. One of the most powerful concepts researchers use is "emergence."

Pain is an emergent process, which means it arises from many different contributors acting together, with no single "boss" in charge. Unlike a linear process where A causes B, an emergent process can be influenced by nudging any of its multiple inputs.

This concept is reflected in some of the world's oldest cultures. At the EP3 2025 conference, Trev Barker noted that in some Aboriginal languages, the closest translation for "pain" is “loss/breakdown of relationship.” This profound idea suggests that pain isn't just a physical sensation but an experience related to our connection with our body, our environment, and our life.

This shift in perspective is incredibly powerful. When pain is a "thing," you are its passive victim. But when pain is an emergent process, you become an active participant with many different points of entry for influencing the outcome and, ultimately, changing your experience.

2. 'Wear and Tear' is a Myth. Your Body is Built to Adapt and Repair.

One of the most persistent beliefs, especially for those with a diagnosis of osteoarthritis (OA), is the idea that joints simply "wear and tear." We're told to "save what we've got" by avoiding activity. Science shows this is wrong. Far from being a simple mechanical problem, OA is a whole-body process involving inflammation, with contributors ranging from gut health to our thoughts. Your body, including your cartilage, is a living, adaptive system designed for load.

Consider these surprising facts about cartilage health:

• Cartilage health is measured by components like Glycosaminoglycan content (GAGs). A study on sheep showed that just one month of immobilization reduced GAGs by 20%.

• Astronauts returning from space experience dramatically reduced cartilage because they haven't been exposed to the normal loads of gravity.

• Contrary to popular belief, studies show that marathon runners actually have healthier cartilage than non-runners.

• Any movement, whether it’s weight-bearing or not, improves cartilage health.

Even the dreaded "bone on bone" diagnosis is a misleading concept. There is always a lubricating protein called lubricin present in the joint. The key takeaway is that your body is designed to adapt. The goal isn't to avoid activity but to find your "sweet zone of change": not too little and not too much, but as much as you can safely do.

3. Those 'Flare-Ups' Aren't Re-Injury. They're 'Protective Events'.

For anyone on a recovery journey, a sudden flare-up of pain can be terrifying. It's easy to assume you've undone all your progress or, worse, caused new damage. This fear can send you right back to square one, avoiding movement and feeling hopeless.

David Butler suggests we reframe this experience. Instead of a "flare-up," call it a "protective event." This isn't just a word game; it's a more accurate description of what's happening. Because pain is an emergent process with many inputs (thoughts, fears, movements), it makes sense that the system's "protective events" are also influenced by more than just tissue status. Crucially, these events almost always occur within your body's "safety buffer zone"—long before you are close to causing any tissue damage.

Normalizing these events is a critical part of recovery. They are a predictable, albeit frustrating, part of the journey. The goal isn't to prevent them entirely but to have a plan to manage them, to understand them, and to learn from them without shame or fear.

4. You Can't Be 'Taught' Your Way Out of Pain—You Have to Build Your Own Understanding.

The old model of healthcare was often based on an expert simply telling a patient what to do. The modern educational theory of constructivism explains that real knowledge isn't passively received like water poured into a container; it is actively built by the learner.

An old saying in rehabilitation once dismissed education by claiming, "Information is to behavior change as spaghetti is to a brick." The modern understanding flips this on its head. The problem isn't the information (the spaghetti); it's that you can't just throw it at a problem.

This explains why simply being handed a pamphlet or told "exercise is good for you" so often fails to create real change. Information has to be delivered and integrated in a way that allows the learner to construct their own "brick"—a solid, personal understanding.

This idea is captured perfectly by the linguist and philosopher Noam Chomsky:

This is ultimately empowering. True reconceptualization and lasting behavioral change come not from being told what to believe, but from building a personal understanding that fits into your world, your values, and your lived experience.

5. Feeling Aches? Remember ABBA.

Our bodies are not static. They are constantly adjusting to the demands of our lives—what we did yesterday, how we slept last night, what we're planning to do today. It's perfectly normal to experience aches and pains as part of this process, but a sensitive nervous system can interpret them as a sign of danger or damage.

When you feel an unexpected twinge or ache, thinking "Ah, an ABBA" reframes the sensation. It’s not a threat; it’s just your system making a normal adjustment. This simple tool helps remind you that your body and brain are an adaptive, living system. As researcher Tasha Stanton notes, "Bioplasticity is ever present. Always. Even at 98 years old." Our bodies and brains are in a constant state of adjustment and learning, and ABBAs are just a normal part of that beautiful process.

Conclusion: Rebuilding Your Relationship With Your Body

The journey out of persistent pain isn't about "fixing" a broken part. It's about rebuilding a relationship with your body based on a new understanding. By understanding pain as a changeable process and our bodies as adaptive rather than wearing out, we can reframe flare-ups as protective events instead of re-injury, build our own deep understanding, and use simple tools like ABBA to manage daily aches with confidence. The common theme is that your body and brain are not fragile machines destined to break down. They are a dynamic, adaptable, and incredibly resilient system capable of change.

Healing begins when you reconceptualize the problem and recognize your own power to influence the process. With that in mind, here is a final question to consider:

If pain is a changeable process, not a permanent fixture, what is one small thing you could change today to start nudging that process in a better direction?