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Pain and the Power of Resemblance

The scientific understanding of pain has evolved over time, and in July 2020, the International Association for the Study of Pain (IASP) updated its official definition of pain:
 
"An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage."
 
At first glance, this definition seems straightforward. But there’s one small yet profound phrase"or resembling that associated with… tissue damage."
What does it mean that pain can resemble tissue damage?
(the first picture is my wife, when I met her. The bottom pictures are of the actress)

The Concept of Resemblance

To illustrate this, let me share a personal story.
When I married my wife, Esther, many people told me and I agreed that she resembled a popular actress at the time, Hyun Jung Ko. Her cheekbones, hairstyle, and facial structure had a similar look. To me, the resemblance was good enough and I said let's get married!
 
But here's the key point: Resemblance is not the same as reality. My wife was not Hyun Jung Ko—she simply looked like her.
 
The same principle applies to pain
 

Pain That Looks Like an Injury—But Isn't

 have back pain. Some days, it feels like I’ve broken a bone. Other times, my shoulder aches as if the tendons and joints are torn. My knee throbs and swells, making it seem as if something inside is completely ripped apart.
But when doctors run MRIs and X-rays, they find nothing wrong. No fractures. No torn tendons. No visible reason for the pain.
How is this possible?
The pain resembles tissue damage—but there is no actual tissue damage.
And that’s where so many people—patients and doctors alike—get thrown off.

The Search for an Injury That Doesn't Exist

When we feel pain, we naturally assume something is physically wrong. We expect a doctor to find the problem—a broken bone, a herniated disc, a compressed nerve. We want a clear diagnosis so it can be fixed.
But what happens when the tests come back completely normal?
This is where the confusion starts. The doctor scratches their head and says, "I don't see much on your MRI or X-ray. I don’t know why you’re in so much pain."
In medical notes, the doctor might write:
✔️ Pain out of proportion to diagnostic findings
✔️ No explanation for the patient's pain based on objective results
And just like that, you're dismissed. Still in pain. Still searching for answers.

The Endless Search for a Diagnosis

Patients in this situation often go from doctor to doctor, searching for someone who will find the "real" cause of their suffering. They may try physical therapy, injections, even surgery—yet the pain continues.
Why?
Because the problem was never an injury to your bodily tissue to begin with. The pain only resembled tissue damage. You suffered an injury. That injury healed a long time ago. That injury is no longer driving your pain. It only feels like an on-going injury!

Breaking Free from the Cycle

Here’s the good newsonce you understand this concept, much of the mystery surrounding chronic pain disappears.
✔️ Your MRI and X-ray results are normal—not because the doctors missed something, but because your pain isn’t caused by structural damage. Diagnostic studies only reveal structural problems.
✔️ The pain you feel is real, but it is not due to a broken bone, a torn tendon, or a compressed nerve. Your pain is only resembling tissue damage.
✔️ You don’t have to be afraid that moving your body will make things worse—because there’s nothing structurally wrong.
Understanding that pain can resemble tissue damage without actual injury is the first step toward breaking free.

The Start of Your Recovery Journey

This realization is the beginning of your healing process. Your brain needs to know that your body is intact, that there is no hidden injury needing repair.
Once you accept this, everything can change.
Your pain is real—but so is your ability to heal. And now, you finally have the key to unlock that path.

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