How are pain and fat loss related? Part I

Last week, I posted a TED talk on why dieting fails for most people. Next week, I’m going to talk about how pain and fat loss are related, but first we need to set the stage by talking about how pain works.

Have you ever wondered how someone could have “phantom limb pain” in an amputated arm? Or how a placebo can work for pain relief? Or how a soldier can get shot on the battlefield and not notice it until several hours later?

Have you ever noticed that your back pain or knee pain or headache can get worse if you’re having a bad day at the office, or a fight with your spouse, or if Justin Bieber is playing in the background?

Did you know that a large portion of people with a spinal disc injury experience no pain at all? And on the flip side, that a ton of people with back pain will get an MRI that shows perfectly healthy discs?

All pain is in the brain

This is because pain is controlled by the brain, not by “pain receptors” in your body. In fact, you don’t have any pain receptors. I repeat, there is no such thing as a pain receptor. All you have is a brain that picks up some signals from the body (like pressure, heat, etc.).

If your brain interprets some of those signals as a threat to your survival or your body, it creates the perception of pain to get you to stop doing that thing you’re doing (“don’t take another step on that sprained ankle — you’ll do more damage to that joint and then we won’t be able to hunting for impalas, okay?”), or to get you to pay attention to the injury.

If you look at pain this way, all of the questions I asked above aren’t so mysterious. Phantom limb pain is pain that your brain creates — and the fascinating thing is that your brain can create pain in a limb that doesn’t even exist! (In another TED talk, here’s neuroscientist VS Ramachandran talking about how he developed a cure for phantom limb pain by using a $3 device that he made himself.)

For that matter, pain from a gunshot wound is also a perception of pain that your brain creates in response to a perceived threat.

So all pain is “in your head.” This doesn’t mean that you’re imagining it, or that you’re making it up. It just means that your brain is perceiving a threat and is using a very effective tool to get you to notice the threat.

This is why your brain may choose not to create the perception of pain. If you’re a soldier in a firefight, your brain may decide that the minor gunshot wound in your shoulder isn’t really as big of a threat to you as the angry guys with grenade launchers who are aiming at you right now. So it’s not uncommon for soldiers not to notice that they’ve been shot until later, when the fighting has died down.

This is also why some people have a disc injury but no back pain. A compressed disc or even a bulging disc may not pose any perceivable threat to the system. This happens frequently enough that an MRI for back pain is really unnecessary in the majority of cases. In fact, it can be harmful if the MRI picks up a “disc injury” and you get shipped off for an unnecessary surgery that won’t make your back feel any better.

Finally, this explains how I had severe foot pain for eight years even though there was nothing wrong with the tissues of my feet. In my case, my brain perceived a threat (“you’re going to do some serious damage to your feet if you don’t sit down right now. Your glutes aren’t working so the calves and feet have to work overtime… why don’t you go take a seat over there and give them some rest? No? Well, I’m going to make your feet hurt so bad that you’ll have to sit down. HAHAHAHA”).

So to recap: pain is a perception created by the brain, in response to a set of signals that the brain interprets as a threat. In some cases, you may not feel pain even with a severe injury. In other cases, your brain can manufacture pain even if there is no tissue damage — this really sucks, by the way, when you are in pain and the doctor says “there’s nothing wrong with you. It’s all in your brain.”

Okay, stay tuned next week for Part II, where I’ll explore how we can use some of these concepts to attack the problem of fat loss without dieting!