What If Pain Was Just Your Body Asking for Balance?

Have you ever felt pain creep in after a stressful day or tough workout, even when nothing was technically “wrong”?
No injury. No big trauma. No obvious cause.
Just… pain.

That experience might seem mysterious — or frustrating — but it’s not a glitch.

It’s your body doing exactly what it’s designed to do.

Let’s unpack a game-changing idea that could help you understand your pain differently — and manage it more gently, wisely, and effectively.

Pain Isn’t Just a Warning — It’s a Message from Inside

We’ve been taught to think pain equals damage.

Twist an ankle → pain.
Throw out your back → pain.
Easy, right?

But what if pain could happen without damage?

What if pain sometimes comes from your internal chemistry being off balance — like when you’re inflamed, overly acidic, exhausted, or just run down?

That’s exactly what a fascinating study by Kelly et al. (2013) showed — and it lines up perfectly with the work of neuroscientist Bud Craig, who describes pain as a “homeostatic emotion.”

Translation?

Pain is your body’s way of saying: “Hey — things inside aren’t okay. Help me find balance.”

This Chart Sums It Up Perfectly 👇

In the study, researchers injected a mix of chemicals into people’s muscles — things your body naturally makes during exercise, like:

• Lactate (produced when things get anaerobic)

• ATP (your body’s energy currency)

• Hydrogen ions (acid), which lower pH and increase acidity

Each mix mimicked what happens inside your body under increasing stress — from light movement to intense exercise or ischemic conditions (like blood flow restriction).

And here’s what happened:

• At low doses (near normal pH), people felt non-pain sensations — stuff like heaviness, fullness, warmth, twitching, or fatigue.

• As the chemical levels increased and acidity rose, people started reporting pain — often described as dull, hot, or aching.

• At the most acidic condition (pH 6.6), 100% of participants reported pain, even though there was no injury.

In other words:
Chemistry alone was enough to make people feel pain.

Why This Is Such a Big Deal

This study proves something many people with persistent pain already feel deep down:

You don’t need a torn ligament or disc bulge to feel pain.
You just need your internal system to be under pressure — physically, chemically, emotionally — and your brain will signal pain as a way to get your attention.

Bud Craig’s research puts it beautifully:

Pain is a homeostatic emotion — a feeling that motivates you to restore balance, just like thirst or hunger.

That means pain isn’t just an “alarm system” or a brain misfire.
It’s your body’s way of saying,

“I’m out of rhythm. Please slow down, adjust, and support me.”

🧪 What This Graph Really Shows (in Plain Language)

At the most intense level (similar to blood flow restriction or overtraining), everyone felt pain — even though there was no damage, no injury, and no emotional context.

💡 Why this matters:
It proves that your body alone — without needing an injury or a psychological trigger — can send signals up to the brain that are strong enough to cause real pain.

🚨 Bottom-Up Pain, No Damage Required

This graph breaks the myth that pain only happens when:

1. You’re hurt

2. Your brain “misinterprets” safe signals as dangerous (which is the focus of many modern pain education models)

Instead, it shows:

Sometimes your body chemistry alone can push the system into pain — even if there’s nothing structurally wrong.

Your muscles and tissues have sensors that detect acidity, fatigue, and other signs of internal stress. When those sensors are triggered enough, they fire pain signals straight up the spinal cord to your brain.

No story. No emotion. Just raw, bottom-up input.

🧭 So What’s the Takeaway?

If you're in pain and nothing seems “wrong” on your scans, you’re not imagining it.
Your body might just be in a state of imbalance, and the signals are getting loud.

This is why recovery often needs more than mindset work — it needs real support for your physiology:
hydration, breathing, rest, movement, and rhythm.

So… What Do You Do With This?

If pain is your body’s call for balance, then managing pain becomes less about “fixing” and more about listening + supporting.

Here’s how that might look in real life:

1. Zoom Out from the “Injury” Narrative

If your pain isn’t linked to a fresh injury, consider:

• Am I underslept?

• Stressed or emotionally stretched?

• Under-recovered from training or work?

• Eating or drinking in ways that support or stress me?

Sometimes, it’s not about the area that hurts — it’s about the system being overloaded.

2. Respect Your Chemistry

That graph didn’t lie:
Your pain may just be your body saying,

“Hey, it’s getting acidic and inflamed in here. Can we chill?”

So…

• Hydrate well

• Prioritize sleep

• Breathe slowly, especially under pressure

• Move gently (to encourage circulation, not exhaustion)

3. Feel First, Fix Later

Instead of immediately chasing solutions, try noticing what your body is asking for.
Sometimes it’s rest.
Sometimes it’s gentle movement.
Sometimes it’s just a moment to breathe and regroup.

Pain is often louder when the system is overwhelmed and under-heard.

Final Thought

Pain is real. It can be awful, disorienting, exhausting.

But it’s not always damage.
It’s often information. And your job isn’t to silence it — it’s to tune in, understand it, and respond wisely.

As Lao Tzu said:
“Do you have the patience to wait until your mud settles and the water is clear?”

That’s what self-care can be when we treat pain as a guide, not a glitch.

So next time your body whispers (or yells),
Don’t just ask “What’s wrong with me?”
Ask:

“What is my body trying to say — and how can I support it today?”

🔗 Exogenously Applied Muscle Metabolites Synergistically Evoke Sensations of Muscle Fatigue and Pain in Human Subjects
Authors: Kelly, L.A., et al.
Journal: The Journal of Physiology (2013)

Want to learn more and see how this makes sense through a case study ? Read on…

🎯 Case Study: Mark’s Lower Back Flare-Up and the Model That Finally Made Sense

Mark, a 44-year-old graphic designer and father of two, has had on-and-off lower back pain for about five years. He’s fit, doesn’t sit too much, and has no major injuries in his history.

But one week, after a few late nights, some emotional stress at home, and pushing through a few intense gym sessions, he wakes up and…
BAM — his lower back locks up again. Sharp, aching pain. Muscle tightness. Fear floods in.

Here’s how three common pain models would explain what’s going on — and how only one of them actually helped Mark feel seen and supported.

🩻 1. The Biomedical Model

What it says:

“You probably strained something again. Maybe your disc or facet joint is irritated. Better stop lifting and get some scans.”

What Mark does:
He rests, pops anti-inflammatories, and stops training altogether. His scan shows a mild disc bulge (which he already knew about). Nothing new, but now he’s more afraid.

Result:
Frustration, fear of re-injury, and no real answers. The pain slowly fades, but the anxiety remains.

🧠 2. The Pain Neuroscience Education (PNE) Model

What it says:

“Pain doesn’t mean damage. Your brain is just interpreting signals as dangerous because of stress or past experiences. Try reframing your thoughts and keep moving.”

What Mark does:
He tries not to catastrophize. He tells himself “I’m safe.” He walks. He does a few gentle stretches and tries mindfulness. It helps… a little.

But deep down, he still feels like something in his body is off.
He’s told “trust the process,” but the pain lingers. He starts doubting himself.

Result:
Less fear, more confusion. He's doing “everything right,” yet still feels pain.

🌡 3. The Homeostatic Model (Bud Craig’s Approach)

What it says:

“Your pain is real. And your body is telling you something is out of balance — not broken, but dysregulated.”

It’s not just your thoughts. It’s your chemistry:

• Poor sleep

• Emotional stress

• High-intensity training without recovery

• Low-grade inflammation

These all impact your body’s internal signals — and when the system gets overwhelmed, your brain sends the message: PAIN.

What Mark does:
He reflects.
“Ah — I’ve been skipping sleep. Stress is high. I trained hard but didn’t recover.”
He doesn’t panic. He doesn’t stop moving. But he also doesn’t push through.

Instead, he:

• Adjusts his training for the week

• Prioritizes rest and hydration

• Focuses on steady breathing and slow walking

• Eats anti-inflammatory meals

• Lets his system settle

Result:
Within a few days, the pain eases without fear. He feels more confident, not because he ignored the pain — but because he listened to it.

✅ Takeaway: Pain as a Homeostatic Emotion

Mark’s back wasn’t “broken” — his body was overloaded.

The biomedical model told him he was fragile.
The PNE model told him it was just his brain.
The homeostatic model? It told him his body and brain were working together to send a useful signal.

And that changed everything.

Is It Time for a New Pain Model?

Is It Time for a New Pain Model?

In the early 2000s, pain neuroscience education (PNE) emerged as a revolutionary approach to understanding pain, spearheaded by prominent figures like Lorimer Mosley and David Butler.

Their work shifted the conversation away from a purely structural perspective and introduced the world to the concept that pain is not solely a result of tissue damage, but also a brain-driven phenomenon.

For some in the rehab profession, this helped us move beyond simplistic reductionist narratives (some other practitioners continued the narrative - see below).

How many overly simplistic nocebic inducing narratives could you fit in one physiotherapy session?

This was an exciting revelation at the time, and it gave clinicians and patients alike a new way to explain chronic pain.

However, as the years have passed, it’s become increasingly clear that PNE, while groundbreaking, may not have fully lived up to its promise.

Many have “drunk the Kool-Aid,” so to speak, fully subscribing to the PNE narrative without recognizing its limitations.

As a result, it may be time for a new explanatory model—one that embraces both the brain and the body in a more profound and grounded way.

Enter Bud Craig’s homeostatic model.

The Cognitive Focus of PNE: A Double-Edged Sword

Butler and Mosley’s PNE revolution gave us the gift of understanding the brain's role in pain perception.

It showed that pain is a complex experience that involves more than just signals from the body—our thoughts, beliefs, and prior experiences shape how we experience pain.

This has led to cognitive-based interventions aimed at reshaping our understanding of pain, helping patients reframe their pain experience and reduce fear.

But this approach has its downsides.

The heavy focus on cognition—the idea that it’s all in the brain—can stigmatize patients, making them feel like their brain is "broken" or diseased.

Just today I heard on the Curable podcast (link here - 38 min mark) Sophie Hawley-Weld discuss her negative experience with PNE as a stand alone approach - “It made me feel crazy, because I did ALL the things!”

Lisa Feldman Barrett points out in her book How Emotions Are Made:

“Scientists now consider chronic pain to be a brain disease with its roots in inflammation.”

Therapists, too, can get stuck in this model, sometimes doubling down when their approach doesn’t yield results, leading to frustration and cognitive dissonance on both sides.

While PNE has helped many, its reductionist trap—the idea that pain is purely a cognitive or brain-based experience—can leave patients feeling confused, alienated, and in some cases, harmed.

The Quiet Work of Bud Craig: A Model Ready for Its Time

While PNE experts have been front and center, promoting their work as being of the highest evidence-based standard, Bud Craig has worked quietly and diligently in his lab for over two decades.

Without any fanfare or jumping to premature conclusions, Craig has steadily built his homeostatic model of pain, focusing on understanding how the brain and body interact to maintain balance. His approach has been one of careful observation and deep research, avoiding the sensationalism that often accompanies new theories.

Unlike the self-promotion that has often characterized the PNE movement, Craig’s work has been humble yet profound.

While PNE experts have confidently marketed their approach and, at times, looked down on therapists who use what they consider to be outdated modalities, Craig has taken a more measured, thoughtful path.

This divide between the PNE camp and other healthcare professionals has created divisions within the profession that threaten to tear it apart. As the PNE model gained traction, those who embraced different methods, even those rooted in manual therapy or movement-based approaches, have often been labeled as being behind the times or lacking evidence.

This division is unhealthy.

When experts adopt a fixed stance, particularly when that stance dominates the conversation, it can prevent the evolution of new ideas.

The rigid adherence to the neuromatrix theory has made it difficult for PNE proponents to integrate other valuable insights, particularly those that focus on the body’s physiological processes.

Bud Craig’s Homeostatic Model: A More Balanced Approach

This is where Bud Craig’s homeostatic model offers a refreshing alternative.

Craig’s model doesn’t disregard the brain’s role, but it brings the body back into the equation in a more meaningful way. His model focuses on interoception—the way the brain perceives signals from inside the body—and homeostasis, or the body's ability to maintain internal balance.

Craig suggests that pain emerges from the brain's interpretation of signals related to disruptions in homeostasis.

In other words, pain is a result of the body trying to maintain balance, involving not just cognitive processes but also metabolic health, the immune system, and the autonomic nervous system.

This multi-dimensional approach goes beyond the brain to include a broader understanding of the body's physiological state.

Why PNE Has Reached Its Limits

The current PNE model, with its strong focus on the brain, misses out on these broader dimensions. While it’s been helpful for some, it has also led to iatrogenic harm—the unintended negative consequences of treatment.

Patients who don’t respond to PNE can feel as though their brain is at fault, or that they’re failing to think positively enough to overcome their pain. This can lead to a sense of disempowerment, where patients feel like they’re not in control of their own healing.

On the flip side, therapists who are deeply invested in the neuromatrix theory of pain, popularized by PNE, can become stuck in their thinking.

They may struggle to embrace newer models like Craig’s, falling into expert bias and resisting change due to their commitment to a theory that no longer fully explains the complexity of pain.

Big organizations or thought leaders who have built their careers on the neuromatrix theory may find it difficult to pivot, even when emerging evidence suggests a new direction is needed.

The Risk of Reductionism

When we boil down pain to a purely cognitive process, we risk oversimplifying a very complex experience.

Pain is not just in the mind, and it’s not just in the body—it’s an emergent experience that arises from the brain’s interpretation of the body’s internal state.

PNE’s reductionist approach may have been a necessary stepping stone, but it’s clear now that it’s not enough.

We need a model that honors the complexity of pain—one that integrates the brain, body, and emotions.

A New Paradigm for Pain: Bud Craig’s Homeostatic Model

Bud Craig’s homeostatic model offers the kind of paradigm shift that the pain world desperately needs.

His model moves beyond the brain-centric view of pain and looks at how pain is a signal of the body’s struggle to maintain balance.

It integrates brain and body, cognition and physiology, offering a more multi-dimensional and empowering view of pain.

This model suggests that pain is not just about faulty neural circuits or maladaptive thoughts but is a multi-dimensional signal that can arise from metabolic imbalance, poor immune function, or disruptions in the autonomic nervous system.

In this way, it respects the body's role in pain, and it offers patients a more empowering framework for understanding their pain and healing.

Instead of being told that their brain is “the problem,” patients can see how their body and brain work together to maintain balance.

Time for a New Direction

As with any scientific revolution, there comes a time when we must move forward. Karl Popper’s philosophy reminds us that science should be open to change, that we must always be ready to discard old theories when new evidence challenges them.

The PNE revolution, while groundbreaking, may now need to give way to a more nuanced, integrative approach. The homeostatic model offers a new direction—one that respects the brain’s role but also fully embraces the body’s physiological contributions to pain.

It’s time for a new pain model—one that’s more grounded in science, one that empowers patients rather than stigmatizing them, and one that helps therapists and patients alike see the bigger picture.

The time for Bud Craig’s homeostatic model has come.

Final Thoughts:

We owe a debt of gratitude to Butler, Mosley, and the pioneers of PNE for opening the door to a new understanding of pain.

But now, we have the opportunity to take the next step. By embracing the homeostatic model, we can help patients reclaim their power, and in doing so, move away from the reductionist trap that has limited our approach to pain for too long.

Let's bridge the divisions in the profession and build a new, unified path forward—one that honors both the brain and the body.

A new view of pain

“A new view of pain as a homeostatic emotion Bud Craig”.

Neuroscientist Bud Craig wrote this research paper 20 years ago.

I just discovered in last year and was blown away by the explanation of pain through the lens of homeostasis and interoception.

It links the body and brain in a plausible and scientific explanation that is based on Mr Craig’s decades of pain staking anatomical dissection and innovative tracing methods.

Currently as a society we are going through a epidemic of pain.

Our traditional models are not helping.

It could be argued they are making the problem worse due to iatrogenic harm.

Once you are caught in the biomedical matrix, it is very challenging to escape.

I found this paper to be a game changer as it helps us to use a m0re accurate explanation of pain that links body and brain in a way that is much more empowering.

Subsequently I have been reading more of Mr Craig’s work as well as his amazing book.

Making sense of pain is arguably the greatest therapy there is.

I have included the full PDF in the link below.

Some of the highlights from the research paper I have also outlined below.

As it is written for a scientific lens, if you reading this and would likely to comment or connect to find out more - just leave a message below or send me an email dan@kinfolkwellness.com.au

“Pain is both an aspect of interoception (the sense of the physiological condition of the body) and a specific behavioral motivation. This striking conceptual shift incorporates the multiple facets of pain into one concrete framework, and it provides sound explanations for pain as both a specific sensation and a variable emotional state”.

“Changes in the mechanical, thermal and chemical status of the tissues of the body – stimuli that can cause pain – are important first of all for the homeostatic maintenance of the body.”

“Pain normally originates from a physiological condition in the body that automatic (subconscious) homeostatic systems alone cannot rectify, and it comprises a sensation and a behavioral drive with reflexive autonomic adjustments.”

“The behavioral drive that we call pain usually matches the intensity of the sensory input but it can vary under different conditions, and can become intolerable or, alternatively, disappear, just as hunger or thirst.”

“The new view of pain as a homeostatic emotion arises directly from functional anatomical findings in cat and monkey, rather than from philosophical considerations.”

“These results have identified specialized central substrates that represent pain, temperature, itch, muscle ache, sensual touch and other bodily feelings as discrete sensations within a common pathway.”

“These data indicate that in humans pain is an emotion that reflects specific primary homeostatic afferent activity.”

“Activity that produces pain in humans ascends in this pathway because its primary role has been homeostasis for millions of years.”

“Humans experience increasing discomfort at temperatures below 24C, but cold does not normally produce pain until 15C, where HPC activity accelerates and, significantly, cooling-specific lamina I cell activity plateaus.”

“This physiological evidence confirms the anatomical finding that homeostasis, rather than the heuristic simplification ‘nociception’, is the fundamental role of the small-diameter afferent fiber and lamina I system and is the essential nature of pain.”

“These findings indicate that pain in humans is a homeostatic emotion reflecting an adverse condition in the body that requires a behavioral response.”

“The new findings provide specific substrates for each of these aspects within a common framework of homeostasis.”

“This new view differs fundamentally from the prior conventional view in several ways. It incorporates specific sensory channels for different kinds of pain and for pain of different tissue origins. It provides a fast (sharp) pain channel that can elicit fight-or-flight behavior and a slow (burning) pain channel that can engage long-term responses, sickness behavior and immune function”.

“This perspective suggests new directions for research that could have strong impact on clinical therapy. For example, other homeostatic variables, such as salt and water balance, could have direct impact on the integrated activity that underlies the motivation called ‘pain’, as in the mysterious fibromyalgia syndrome.”

“Understanding the mechanisms underlying the augmentation of activity in the polymodal nociceptive channel could be particularly fruitful for identifying new therapies for chronic pain.”

"Back to the Body": Charting a New Course in Physiotherapy

In the dynamic field of physiotherapy, a transformative wave is reshaping our traditional approaches to pain and injury.

This evolution, termed "Back to the Body," represents a significant departure from past practices, integrating modern science's revelations with a renewed focus on the body's intricate signals.

As we delve into this shift, it's essential to appreciate the context from which we're moving and the promising direction in which we're headed.

The Traditional Paradigm: A Focus on the Physical

Historically, physiotherapy has been deeply anchored in a biomedical model, concentrating on the body's physical aspects—its joints, muscles, and tissues.

This approach, while foundational, often adopted a reductive lens, aiming to "fix" what was perceived as broken or misaligned.

Diagnoses frequently highlighted deficiencies: a "weak" core, "tight" muscles, or "improper" posture.

While these assessments were made with the best intentions, they inadvertently introduced a nocebo effect, where the negative framing of conditions could exacerbate patients' perceptions of pain and disability, sometimes with minimal relevance to their actual experience of pain.

The Shift Toward Mind and Emotion

The field's expansion to encompass beliefs, emotions, and the broader neurocentric model—largely influenced by the pioneering work of researchers like Lorimer Moseley and David Butler—marked a significant leap.

This phase brought to light the brain's integral role in pain perception, advocating for a more comprehensive understanding that transcends mere physicality.

However, this shift, for all its merits, occasionally led to an overemphasis on the psychological at the expense of the physical.

Patients sometimes felt their pain was being dismissed as purely a construct of the brain, leaving them feeling invalidated and overlooked.

"Back to the Body": A Holistic Reintegration

Today, we stand at the precipice of a new era, inspired by Bud Craig's insights into homeostatic emotions and the complex interplay between mind and body.

"Back to the Body" advocates for a return to a more integrated approach, where pain is recognized as an interoceptive signal—a cue from our body indicating a need for attention and care.

This perspective sees pain not as a mere symptom to be eradicated but as a critical piece of feedback within our body's attempt to maintain balance.

With advancements in technology—such as heart rate variability monitors, blood glucose tracking, and sensors for lactate and inflammatory markers—we're now equipped to decode the body's signals with unprecedented clarity.

This technological leap, combined with principles of load management as outlined by Tim Gabbett, empowers us to identify and respond to the body's cues more effectively, fostering an environment where positive adaptations are more likely.

Empowering Through Understanding

This shift towards an integrated mind-body model is about empowerment and education.

It's about guiding patients to tune into their bodies' messages, recognizing the signals of overload and stress.

It encourages a response to discomfort informed by understanding and mindfulness, rather than fear or the pursuit of immediate fixes.

This approach demystifies the sensations we've labeled as pain, reframing them as part of our body's broader context of response.

Moving Forward

"Back to the Body" heralds a return to physiotherapy's roots, enriched by our journey through the realms of psychology and neuroscience.

It's a call to embrace the body's complexity, leveraging science and technology to deepen our connection with ourselves.

As we chart this new course, we embrace a model of care that is both empowering and educative, one that places the patient's experience at the forefront of the healing process.

In doing so, we not only address pain more effectively but also foster a holistic sense of well-being.

Daniel O’Grady