Book Review: Explain Pain

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Explain Pain
by David Butler, Lorimer Moseley

Review by Lindsey Muskett

What if a lesson on brain science could revolutionize the way you manage pain?  This is exactly what David Butler and Lorimer Moseley aim to do in their transformative book titled, “Explain Pain.”  The authors use zany drawings, brilliant metaphors, and humor to introduce concepts that may shift your entire paradigm on what pain is and, more importantly, what you can do about it.  

This book challenges the commonly-held assumption that tissue damage causes chronic pain and, instead, offers a powerful argument, based in current neuroscience, that pain is created in the brain.  Hold onto any skepticism about pain being “all in your head” though. The key point that the authors develop beautifully is that pain is only experienced when the brain perceives a threat! Pain is like an alarm system, a protection mechanism that’s become a bit (or maybe a lot!) too sensitive.  Think about a fire alarm that rings when a single candle is burned three rooms away.

The authors provide example upon example of how thoughts, beliefs, emotions, expectations, context and other factors play into the sensitization of the pain response.  For example, the book explores answers to questions like why does a violinist experience more pain from a finger injury than a professional dancer? How does your relationship with your boss affect your pain levels?  How can an amputated limb feel pain? Rooted in the answers to all of these questions is the foundational takeaway that pain is created in the brain, “100% of the time, with NO exceptions,” as the authors point out. This is a powerful concept that provides hope for healing because the brain can be re-trained.  Just like a muscle adapts to the load put on it, the brain adapts to the input it is given. Changing that input is likely the secret sauce that the reader takes away at the end of the book.

Although the reader is not going to come away with a quick fix for chronic pain, the book is refreshing and empowering.  For readers who find themselves feeling a little stuck in the weeds during some of the science discussion, they should know that the book provides some clear direction and recommendations too.  For example, the authors point out benefits and examples of “active” pain management strategies that incorporate education, pacing, graded exposure to new movement, virtual exercise (or imagery) and changing thought patterns.  At Take Courage Coaching, these are tools that many of our clients benefit from every day. As the authors state, “remember that you are the owner of your pain, no one else. In the end, it is you who has the most power to manage and rid yourself of it.”  For many of us who have been looking for “fixes,” this book introduces concepts that are revolutionary and powerful for managing pain.



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