Dr Hinanna Berjis
Pain is a paradox; something that is felt but can’t be explained. You can show a surgical scar to someone and they would know that you’ve been operated on. You can show your plastered arm and they would understand you had a fracture. But how do you explain pain?
It’s not like your blood sugar that will show in lab tests. Pain is lived. Not even those closest to you will understand the amount of discomfort you carry; hence medical science has come up with scores of pain questionnaires such as the Brief Pain Inventory, Numerical Rating Scale, Visual Analogue Scale, and McGill’s Questionnaire. Yet we still don’t know the exact amount of pain that you feel.
Why is it so? Why haven’t we been able to quantify pain? Why are we so helpless, even in the 21st century, that we haven’t yet figured out why one single dose of paracetamol can cure a headache for one person, while it is totally ineffective for another person with the same complaint?
This paradox has troubled me for years as a physician. Why does some pain persist even when we throw the best of drugs and interventions at it? The answer lies in something both simple and profound: pain is not only in the body; it is in the brain’s interpretation of the body. And that interpretation can be reshaped. This is what I call redefining pain.
Central Sensitisation: When the Brain Rewires
For those who might be wondering if it all depends on a person’s “tolerance” to pain; you might be surprised to know that chronic pain ; that is, pain that has stayed with you on and off for more than three months, actually rewires your brain. What you call decreased tolerance is, in fact, central sensitisation; a medically proven fact.
People with chronic pain feel it in greater intensity than someone who has had the same pain once or twice. The brain and neurons rewire themselves so that what might be a simple touch for you becomes a painful input for them.
So, tolerance isn’t the word we are looking at. We are looking at something called central sensitisation. Patients with fibromyalgia, arthritis, cancer pain, or post-surgical syndromes often find themselves on heaps of medications with limited relief and many side effects. They come to me fatigued, anxious, and sometimes hopeless; carrying not only their pain but also the stigma that “it’s all in their head.”
Ironically, they are right. It is in the head; but not in the dismissive way people think. It is in the way the brain and spinal cord process signals, amplify them, and give them meaning.
Pain Modulation: Changing the Script
The good news is that we are in an era where the perception of pain is already shaping up towards a concept called pain modulation; changing the way our body perceives pain. Instead of merely suppressing pain, modulation seeks to alter the brain and nervous system’s perception of it.
Imagine pain as music playing too loudly on a stereo. Traditional drugs try to cut the wires or block the speakers. Pain modulation turns the volume knob down; or even changes the tune.
Techniques that embody this shift include:
– Spinal cord stimulation: tiny electrical impulses that change how the spinal cord transmits pain.
– Scrambler therapy: delivering “non-pain” signals to re-train nerve pathways.
– Biofeedback: teaching patients to control physiological responses like muscle tension and heart rate.
– Mindfulness and meditation: calming the brain’s pain networks.
– Aromatherapy and relaxation: supporting sleep and restoring balance.
All these modalities teach us to visualise pain as not just something in the body; but something that has a psychological, social, and environmental component as well.
My Journey into Redefining Pain
I come from a background in Anaesthesiology with an MD and a fellowship in Pain Management. For years, I practiced conventional methods ; medications, nerve blocks, and interventions. They helped, but not enough. My curiosity led me to expand into integrative practices, earning a certificate in Mindfulness and Aromatherapy from the University of Minnesota.
At the International Conference on Recent Advances in Pain (ICRA 2025), held in Kolkata, I presented a case that illustrated the power of this approach. A 26-year-old woman with widespread pain, fatigue, and insomnia had not improved on standard medications for the last four years. We introduced a program of guided mindfulness twice a week, daily practice at home, and lavender aromatherapy for sleep support.
Within four weeks, she had cut down on her medication; her pain severity almost halved; her sleep improved; and her energy returned. The results were not only numerical but deeply human. She smiled again, she engaged with her family, she started living.
The global experts who heard this case responded warmly, acknowledging that it represented the shift we are all sensing: medicine must not only treat pain, but redefine it.
The Human Element
I have sat across patients who tell me, “Doctor, no one believes me anymore.” That sentence is often more painful than the pain itself. Redefining pain means restoring dignity, reminding patients that their suffering is real, and showing them that the brain’s narrative of pain is not fixed.
One of my patients once said after a mindfulness session, “I didn’t know I could feel my body without fighting it.” That is the heart of this new era. It is about helping people make peace with their bodies, without giving up on healing.
HB Holistic Pain Management Centre: A Vision for Kashmir
These experiences have shaped my vision for my upcoming project: the HB Holistic Pain Management Centre in Srinagar. It will be the first of its kind in the region, dedicated not just to treating pain but to transforming the way patients experience it.
And I am not just focused on relieving pain, but on shaping lives. From minimal medication to natural practices like mindfulness and aromatherapy, to ultrasound-guided nerve blocks and interventions wherever required; we also have a structured program to help patients heal better. I have even collaborated with designers to launch a series of therapeutic clothing for my patients; alongside a focus on looking and feeling better.
With HB Holistic Pain Management Centre, it is going to be a journey that helps people get back to life in the best possible way. It’s a dream, a vision that I bring to Kashmir; because every person dealing with chronic pain deserves a better, pain-free life.
The Future of Compassionate Science
Globally, the World Health Organization now recognizes chronic pain as a disease in itself. Researchers across continents are exploring how mind-body interventions can rewire the nervous system. India must not be left behind.
Redefining pain is not about dismissing drugs or interventions. They remain vital. It is about broadening the toolbox, making room for therapies that are safe, accessible, and empowering. It is about moving from a war on pain to a dialogue with it.
As I look ahead, I carry the words I spoke at the conference: “Pain may be inevitable, but suffering is not. With the right approach, we can retrain the brain to experience life differently.”
Revolutions in medicine do not happen overnight. They happen quietly, in clinics and living rooms; in the moment a patient sleeps peacefully after years of insomnia; or when pain is no longer the enemy but a manageable part of life.
Redefining pain is not just a medical strategy. It is a philosophy of care; a way of restoring hope. And in the end, hope is the most powerful analgesic of all.
(The author is a pain physician based in Srinagar.)
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