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Part 3 - Pain Science DIMs and SIMs

In the last blog post we explored how nociceptors can become sensitised and how our 'guard dog' can also become overprotective, and that these factors influence our levels of pain.


In this post, I want to explain the concept of pain 'perception'. When our central nervous system receives signals indicating something is going on, your brain has to processes a thousand things to determine the level of threat, and the greater the perceived threat, the greater the amount of pain the brain will cause you to feel.


Important note: historically, and even today, pain is often dismissed as being 'in your head'. However, the reality is that, every sensation we experience comes from the brain – whether you are hot, cold, sunburned, feeling good or feeling pain – none of these sensations would be possible without the processing occurring in the brain. Therefore, pain should never be dismissed as simply being in the head - as if it were a switch someone could simply switch off.


Pain Perception and Pain Science In Action


If you're someone who scrolls through reels, you may have seen viral prank videos of people using "dummy knives" and pretending to stab their friends or relatives.


For a second – the persons brain doesn't know it's a fake knife, and so it perceives that the threat level is high, causing a high level of distress. However, after a few seconds, the brain perceives that there is no blood, no wound, and therefore no damage, then the perception of pain diminishes and the nerves return to a rested state.


So in reality – fake knife, no danger

But in actuality – possibly a real life, a lot of danger, freak out!


How To Influence Your Pain Perception


Now that we have an idea of how your central nervous system and perception influence your experience of pain, the next question is, what can we do to reduce our brains perception of threat?


The Concept of DIMs and SIMs


Our brain is constant scanning our internal and external environment to answer a single question

"how dangerous is this?"

It weighs up two types of signals:

  • DIMs (Danger in Me): These are things that suggest your body is under threat or need protecting

  • SIMs (Safety in Me):These are things that suggest your body is safe, strong and capable.


Think of your pain levels as if they were a scale, when your DIMs outweigh your SIMs, your brain will conclude you are in danger and produce pain.


When you increase your SIMs and reduce your DIMs, the brain feels safer, and the alarm typically turns down.



Why This Matters


Pain is a decision made by the brain based on the sum of all available information. This is why I emphasise education so much when working with chronic pain patients. You don't have to "fix" a tissue to reduce pain, sometimes, you just need to tip the scales.


To lower your pain, you can:


  1. Identify the DIMs

  2. Hunt for the SIMs


In summary, pain is a protective mechanism. By understanding your unique DIMs and SIMs, you can start to turn down volume on the pain alarm, and get back to doing the things you love.


Exercise Sheet

I've attached an exercise sheet you can download and fill out.


I also attached an example sheet of mine from when I had chronic knee pain. One of my biggest DIMs was going on Google and reading that it would need surgery to fully recover. I reckon if I didn't read that I would have recovered in months rather than years!



I hope these posts have given you a slightly better understanding on an otherwise very complicated topic – If you would like to work with me, feel free to reach out and I'd be happy to support you.


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