Have You Ever Thought About the Science Behind Pain?
Pain: we’ve all felt it, but most of us have no idea how it actually works, especially when it’s chronic or linked to conditions like endometriosis. Here’s a hint: pain isn’t always about ‘damage.’ In fact, your brain has a starring role.
Let’s unpack this science (without the medical textbook headache).
Meet Nociception: Your Body’s Alarm System
Ever heard of nociception? Don’t worry if not, you’re not alone. Nociception is the biological process of detecting potentially harmful stimuli (think: extreme heat, pressure, or inflammation) and sending a warning to the brain.
But here’s the twist: nociception is not pain.
Pain is your brain’s interpretation of those warning signals, and that interpretation comes wrapped up with emotions, memory, and even your stress levels.
That’s why you can be in serious pain even if nothing shows up on a scan.
How Pain Signals Work
The body uses specialized nerve cells called nociceptors which are tiny receptors scattered all over your body to detect threats. They send messages to the spinal cord, then up to the brain.
Some brain regions figure out the “where” and “what” (burning, throbbing, stabbing).
Others handle the emotional side (fear, distress, panic associated with the harmful stimulus).
Together, they produce the full (and often miserable) experience we call pain.
Chronic Pain: When the Alarm Won’t Shut Off
Normally, pain helps protect us from injury. But in chronic conditions like endometriosis, nociceptors can become oversensitive—kind of like a smoke alarm that won’t stop screeching at burnt toast.
This is called sensitization:
Peripheral sensitization: the nociceptors themselves become hyper-reactive.
Central sensitization: nerve cells in the spinal cord and brain amplify pain signals.
The result? Pain from things that shouldn’t hurt (allodynia), or extreme pain from mild triggers (hyperalgesia).
Endometriosis Pain: A Complex Story
In endometriosis, pain is multi-layered:
Lesions themselves can trigger pain since they may receive input from nerve fibers.
During menstruation, lesions bleed, causing inflammation and activating nociceptors.
Ongoing inflammation keeps the nervous system in “high alert” mode, even without new damage.
Cross-organ sensitization explains why pain spreads (pelvis, bladder, bowels, back) as they’re all linked by nerve pathways.
And it doesn’t stop there. Central sensitization in endometriosis is tied to migraines, fibromyalgia, depression, fatigue, and sleep disturbances. In other words: it’s not just about the lesions. It’s about how your whole nervous system rewires itself to expect pain.
Your Brain: The Pain Amplifier (or Buffer)
Here’s where it gets even more fascinating: your emotions influence your pain.
Stress, anxiety, and fatigue crank the volume up.
Safety, rest, and support can turn the volume down.
That doesn’t mean pain is “in your head.” It means the mind and body are deeply connected and both deserve care.
Evidence-Based Ways to Manage Chronic Pain
While there’s no one-size-fits-all fix, research shows there are tools that can help:
Gentle movement: Releases endorphins (your natural painkillers).
Pelvic floor physiotherapy: Reduces muscle tension and improves mobility.
Anti-inflammatory diet: Can lower flare-ups and soothe inflammation.
Mindfulness & journaling: Train the brain to reduce pain perception.
Hormonal treatments: Reduce inflammation by suppressing menstruation.
Devices (TENS, neuromodulation): Reset how the nervous system processes pain.
Massage & heat therapy: Calm the nervous system by activating other nerve pathways.
Think of it as building a personal pain management toolkit, one that supports both body and mind.
Endometriosis pain is complex, unpredictable, and very real. But understanding the science behind it can be empowering. It helps you advocate for yourself, experiment with strategies that work for your body, and remind yourself that the pain is part of your story, but it doesn’t get to write the ending.
References
Kendroud, S., Fitzgerald, L. A., Murray, I. V., & Hanna, A. (2022, September 26). Physiology, Nociceptive Pathways. StatPearls [Internet]. Link
Maddern, J., Grundy, L., Castro, J., & Brierley, S. M. (2020). Pain in endometriosis. Frontiers in Cellular Neuroscience, 14. https://doi.org/10.3389/fncel.2020.590823
Ferguson, K. (2024, November 7). The neuroscience of endometriosis. Samphire Neuroscience. Link
Endometriosis and the nervous system. Women’s and Men’s Health Physiotherapy. (2023, October 31). Link
Pelvic floor physio for endometriosis. Hamilton Physio & Rehab. (n.d.). Link
Haverland, R. (2025, May 19). Stress management techniques for endometriosis relief. Rachael Haverland. Link