Pain is one of the most common reasons people seek medical attention. Whether it’s a sharp injury from an accident or a chronic condition like arthritis, pain affects millions worldwide and profoundly impacts quality of life. But when it comes to treating pain, a fundamental question arises:
Do we treat the body where the pain signals originate, or do we treat the brain, which interprets those signals?
According to Jordan Sudberg, a leading pain management specialist, the answer is far from simple—and understanding the interplay between body and brain is essential to effective pain relief.
Pain: More Than a Physical Signal
Traditionally, medicine has viewed pain as a straightforward response to physical injury or damage. You hurt your knee, nerves send signals to the brain, and you feel pain.
While this explanation holds true in many cases—especially acute injuries—Dr. Sudberg cautions that this model is too simplistic.
“Pain is not just a message from damaged tissue,” he explains. “It’s a multidimensional experience shaped by nerves, the spinal cord, the brain, and even our emotions and memories.”
This complexity means that treating the body alone often falls short, especially in chronic pain conditions.
The Role of the Body: Nociception and Injury
At the biological level, pain begins in the body with specialized nerve endings called nociceptors. These receptors detect harmful stimuli—like heat, pressure, or chemical irritation—and send electrical signals through nerves to the spinal cord and brain.
When you slice your finger or sprain your ankle, nociceptors are the first responders. Treating the body in these cases—through wound care, anti-inflammatory medication, or physical therapy—is critical.
Dr. Sudberg states, “If the tissue is inflamed, infected, or physically damaged, addressing those issues directly is the foundation of pain management.”
The Brain’s Powerful Role in Pain Perception
However, pain doesn’t stop at the spinal cord. It is ultimately the brain that interprets these signals and decides how much pain you feel.
Dr. Sudberg highlights several ways the brain shapes pain experience:
- Amplification: The brain can magnify signals, making pain feel more intense than the original injury would suggest.
- Dampening: Conversely, distraction or positive emotions can reduce perceived pain.
- Memory and Emotion: Past pain experiences, fear, anxiety, and depression heavily influence current pain perception.
- Neuropathic Pain: Sometimes pain arises without any ongoing tissue damage because of nervous system dysfunction.
“Your brain is the final arbiter of pain,” Dr. Sudberg explains. “That’s why two people with the same injury may report very different pain levels.”
Why Treating the Body Alone Isn’t Enough
In many chronic pain conditions—such as fibromyalgia, complex regional pain syndrome, or chronic low back pain—there may be no clear tissue damage, yet patients suffer intense, persistent pain.
Focusing treatment only on the body can lead to:
- Unnecessary surgeries or interventions
- Overuse of opioids or other medications
- Patient frustration when pain persists despite physical treatment
Dr. Sudberg emphasizes that ignoring the brain’s role risks missing the full picture.
“Pain that persists beyond healing often involves changes in how the brain processes signals,” he says. “This is called central sensitization, and it requires a different treatment approach.”
An Integrated Approach: Treating Body and Brain Together
Modern pain management increasingly embraces a biopsychosocial model—recognizing that biological, psychological, and social factors all contribute to pain.
Jordan Sudberg advocates for integrated treatments combining:
- Physical therapies to restore function and reduce tissue inflammation
- Medications targeted carefully to address nerve pain or inflammation
- Cognitive-behavioral therapy (CBT) and mindfulness to reshape pain perception and manage emotional triggers
- Neuromodulation techniques like TENS or spinal cord stimulation to interrupt pain signals
- Patient education so individuals understand pain mechanisms and feel empowered
“Treating pain is rarely about ‘body or brain,’” says Dr. Sudberg. “It’s about understanding the dialogue between them—and intervening at multiple points.”
Case Example: Chronic Back Pain
Take chronic back pain—a common complaint with diverse causes.
- The body perspective focuses on structural problems like disc herniation, arthritis, or muscle strain.
- The brain perspective considers how stress, fear of movement, and past trauma might amplify pain signals.
Dr. Sudberg notes that the most effective treatment plans address both:
- Physical therapy and possibly injections for inflammation or nerve impingement
- Psychological support and graded activity to reduce fear and anxiety
- Pain education to help patients understand the difference between hurt and harm
“Addressing both sides can break the cycle of chronic pain,” he explains.
The Importance of Patient-Centered Care
Dr. Sudberg stresses that no two patients are alike. Tailoring treatment plans to individual needs, preferences, and experiences is critical.
“We listen closely to the patient’s story,” he says. “Sometimes the brain’s role is dominant; sometimes the body’s. The key is to identify the drivers of pain for each person and respond accordingly.”
Patient engagement and education also improve adherence to treatment plans and outcomes.
Advances in Understanding Pain: The Future of Treatment
Recent neuroscience research has shed light on how plastic the nervous system is—meaning the brain and nerves can change and adapt.
Dr. Sudberg highlights promising advances such as:
- Neurofeedback and biofeedback training to retrain pain perception
- Virtual reality therapies to distract and rewire the brain
- Non-opioid pharmacological agents targeting specific pain pathways
- Personalized medicine using genetics to predict effective therapies
“These innovations reaffirm that treating pain is as much about brain science as it is about medicine,” says Dr. Sudberg.
Final Thoughts: Pain Treatment is a Balancing Act
So, do you treat the body or the brain to relieve pain?
The answer is clear: you treat both.
Jordan Sudberg’s expert insight reminds us that pain is a dynamic, multifaceted experience involving body and brain in continuous conversation. Effective pain management must address both the physical sources and the neurological, emotional, and psychological dimensions of pain.
“Understanding this complexity is the first step toward better care,” says Dr. Sudberg. “When we treat the whole person, not just the symptom, we restore hope, function, and quality of life.”