Pain: When The Cause Isn't What You Think

Have you ever experienced pain that seemed to have no explanation? Perhaps you’ve undergone tests, tried treatments, or been told that everything looks normal, yet the pain continues. Few things are more frustrating than being in pain and not understanding why. What if there’s more to pain than an injury, inflammation, or something physically wrong with our bodies? What if our brains, emotions, and nervous systems play a bigger role than we realize?

I’ve always been fascinated by the way our minds work. Freud’s theories intrigued me, although I’ve generally found them more interesting than necessarily factual! I’ve also long believed that our thoughts and attitudes can influence how we experience life’s challenges. My mother, who was a nurse, understood something about this connection. Whenever she was cleaning a wound or removing a sliver, she’d encourage us to concentrate on the wallpaper or something else in the room. The idea was simple: focus your attention somewhere other than the pain, and it might not hurt quite so much. I didn’t know anything about neuroscience back then, but that little lesson stayed with me.

Years later, learning about Dr. John Sarno’s work brought a different perspective to something I’d been curious about for much of my life. Dr. Sarno was a physician specializing in rehabilitation medicine who developed a theory called Tension Myositis Syndrome, or TMS. He believed that some chronic pain could be connected to emotional tension, particularly emotions we may not consciously recognize or express. His theory suggested that feelings such as anger, fear, frustration, and resentment could contribute to physical symptoms. He proposed that the brain could produce pain as a distraction from uncomfortable emotions. Imagine someone who spends years caring for everyone else, rarely expressing frustration, always trying to remain strong. Could that emotional pressure influence how their body feels? Sarno believed it could. His specific explanation for TMS remains controversial, and research has not established that repressed emotions cause chronic pain in the way he proposed. His work does, however, invite us to consider the relationship between emotional well-being and physical symptoms.

That does not mean  that your pain is imaginary! This is perhaps the most important point. Pain is real, even when doctors cannot identify a clear physical cause. Modern pain science recognizes that pain involves more than signals coming from injured tissues. The brain and nervous system interpret information from throughout the body, and that process can be influenced by stress, fear, previous experiences, and emotional well-being. Think about how your body responds when you’re anxious. Your heart may race, your shoulders tighten, your stomach becomes unsettled, or a headache develops. Nobody would suggest those physical sensations are imaginary simply because emotions contributed to them. Pain can be influenced by similar connections. Researchers now recognize a category called nociplastic pain, in which changes in how the nervous system processes pain contribute to symptoms without clear evidence of tissue damage sufficient to explain them. This doesn’t mean all chronic pain works this way. Injuries, inflammation, illness, and nerve damage can also cause pain, sometimes alongside changes in pain processing. Understanding the possibilities can help us ask better questions and explore appropriate treatment.

Looking back, I find it interesting that my mother’s simple advice has a connection to something Scripture teaches us. In Philippians 4:8, Paul encourages us to think about things that are true, honourable, just, pure, lovely, and worthy of praise. God knows how easily our minds can become occupied with fear, worry, and everything that seems wrong. His Word encourages us to direct our attention toward what is good and life-giving. That doesn’t mean ignoring pain, denying difficult emotions, or pretending our circumstances are better than they are. It means recognizing that we have some influence over where we direct our attention. My mother wasn’t suggesting the sliver didn’t exist. She was helping me focus on something other than the pain while she dealt with it. Perhaps there’s a lesson there for how we approach other challenges in life. We can acknowledge what’s hurting without allowing it to occupy every corner of our thoughts. We can seek appropriate treatment, recognize our emotions, and still make room for gratitude, joy, hope, and God’s promises. Psalm 139:14 reminds us that we are fearfully and wonderfully made. Learning about the brain’s role in pain has only deepened my appreciation for how wonderfully God created us. Science can help explain some of the mechanisms behind our experiences, while Scripture offers guidance for how we approach them. The two don’t have to compete.

Sarno’s work raises another interesting question. How often do we acknowledge what we’re feeling? Many women have spent decades caring for children, supporting spouses, managing households, working, and meeting everyone else’s needs. We become very good at saying, “I’m fine,” even when we’re exhausted, frustrated, frightened, or overwhelmed. Those feelings don’t necessarily disappear because we choose not to discuss them. Emotional stress can affect sleep, muscle tension, and pain sensitivity. Recognizing those connections isn’t about blaming ourselves for being in pain. It’s about becoming more aware of what may be contributing to our overall well-being. God invites us to bring our burdens to Him. We don’t have to pretend we’re happy when we’re hurting or strong when we’re struggling. Prayer, honest conversations, journaling, and appropriate professional support can provide opportunities to acknowledge feelings we’ve spent years pushing aside. That emotional honesty has value whether or not it changes our physical symptoms.

Learning about pain doesn’t mean abandoning medical care or assuming every symptom has an emotional cause. New, worsening, or unexplained symptoms deserve proper medical attention. It does mean recognizing that managing chronic pain may involve more than treating one part of the body. Perhaps we can become curious about how stress affects us, how fear influences our willingness to move, or how our thoughts shape our expectations. We can begin exploring those connections without judgment, taking small, sensible steps toward greater confidence and well-being. God has given us the ability to learn, question, and grow in understanding. We don’t need to have every answer before taking the next step. Your pain is real. Your struggles matter. Your life has purpose beyond what your body is experiencing today. Perhaps understanding the remarkable connection between your brain, body, and emotions will open another door toward living with greater peace, confidence, and hope.

Have you ever noticed your physical symptoms becoming more intense during periods of stress or emotional difficulty? What might change if you approached that connection with curiosity rather than fear?

This article is intended for education and encouragement, not diagnosis or medical treatment. Persistent or changing pain should be discussed with a qualified healthcare professional.