Think about jumping into a cold lake. One person surfaces whooping and grinning, ready to go again. Another finds it genuinely painful and cannot get out fast enough.
Or a deep, firm massage. Press hard into one person's shoulders and they melt and ask you to go harder. Do the very same thing to someone else and they grit their teeth and count the seconds until you stop.
Or the thumping bass at a loud concert, thrilling for one person and painful for the next.
Same input every time, and completely different experiences. Pain works like that, and there is a theory that explains why.
It is called the neuromatrix theory of pain, introduced by Dr. Ronald Melzack in the 1990s. The old idea was that pain travels straight from an injury up to the brain, like a wire running from the sore spot to your head: more damage, more pain. The neuromatrix theory says something more useful. Pain is not a message your body sends. Pain is something your brain builds. Your body reports what is happening, and your brain decides what to make of it, then produces the feeling of pain as its answer.
Before your brain settles on how much pain to make, it blends three things:
- Sensory: the physical event, like a contraction, pressure, or a stretch.
- Emotional: how you feel. Fear and stress turn pain up. Calm and safety turn it down.
- Cognitive: your thoughts, your expectations, and what you remember. The scary birth story you heard last year is in here too.
This is why two people can have the very same contraction and feel very different amounts of pain. Their bodies delivered the same event, but their brains built two different results.
It is also why comfort measures work, and why they are not a trick to take your mind off things. When you feel safe and supported, when you can move freely, and when you are in a space that feels good to you, your brain turns the volume down on pain. Steady support, movement, a calm room, and clear information do not just take the edge off. They change the pain itself.
That is the part I love about this theory. The way we care for someone in labor is not fluff around the edges. It is part of the pain.
Based on the neuromatrix theory of pain developed by Ronald Melzack. For the application to labor and non-drug comfort measures, see Trout KK, "The Neuromatrix Theory of Pain: Implications for Selected Nonpharmacologic Methods of Pain Relief for Labor," Journal of Midwifery & Women's Health, 2004.
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