A biopsychosocial experience

It is essential to look at persistent pain from a broad perspective and considering all of the biopsychosocial factors that can impact on your pain experience. As mentioned before, we know that the brain produces pain when the information that it receives is processed as threatening. This is how all pain is produced – be that acute or persistent, sharp or dull, strong or mild.

What we did not mention before is that the brain receives information from many sources, including biological, psychological, and social information. It is the combination of these bio-psycho-social factors that lead to the brain producing or not producing pain.

Some biopsychosocial factors that contribute to the pain experience include:

When we consider the biopsychosocial perspective of pain, it is easier to understand how we all have a unique experience of pain, and how our own pain can be experienced differently at different times. For example, a soldier fighting in a war zone might sustain an injury with serious tissue damage to a leg, but might not feel any pain until in hospital and away from the danger.

It is likely that the soldier’s brain received information from nociceptors (biological factor), but it probably also received information from the soldier’s belief that “if I stay here I will die” (psychological factor). In this situation, the brain decided it is more helpful to not produce pain in the leg, so that the soldier could run away from the danger prioritising survival. It is important to pay attention to these same biopsychosocial factors when thinking about how to manage persistent pain.

This is an overview of understanding pain. As we talk about pain management strategies, we provide more information about understanding particular aspects of persistent pain in our workshops and information booklets.

It is important to note that this explanation of how pain is produced and maintained applies to all conditions including fibromyalgia, EDS, and osteoarthritis, for example.


Pain does not always mean tissue damage is occurring, and having tissue damage does not guarantee pain will be experienced. Pain comes from the brain and it can be retrained. By looking at your pain experience from a broad/whole person perspective, it gives you lots of opportunities to begin making steps towards retraining your brain.

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