The album marked a very distinct stylistic shift for the group, fully moving toward a Ramones-inspired sound and completely abandoning their previous hardcore punk influences as a condition made by vocalist Ben Weasel when reforming the band after a brief break-up.

[3] After the release of My Brain Hurts, the band grew increasingly popular within the punk community and began drawing bigger crowds at their shows,[4] which Weasel later admitted put pressure on him when recording the follow-up album Wiggle the next year.

[6][8] In 2005, the band removed their catalog from Lookout due to unpaid royalties, alongside many other artists, and re-released the album on CD in remastered form though Asian Man Records later that year.

Screeching Weasel briefly reformed in early 1991 to play what was intended to be a one-off reunion show to pay back Russ Forster, who had loaned the band money to record Boogadaboogadaboogada!.

Sewercap would be renamed "Dan Vapid" and moved to rhythm guitar as Weasel wanted to continue focusing on singing.

"[6] Weasel relented and the group traveled to California in July to record the album at Art of Ears Studio in San Francisco with Livermore and Andy Ernst producing.

[4] During the sessions, the group re-recorded a number of older songs from its catalog, including "Slogans", "Kamala's Too Nice", "Fathead" and "I Wanna Be a Homosexual".

While recording the title track, which was named in reference to the Monty Python's Flying Circus sketch "Gumby Brain Specialist",[10] Weasel instructed Panic to play in the style of Aaron Cometbus of Crimpshrine during the drum break.

"[9] Although the majority of the songs on My Brain Hurts were written by Weasel, as was the material on the band's previous albums, he also began collaborating more with Vapid and less with Jughead.

The only song on the album to credit Jughead as co-writer is "Fathead", the original version of which previously appeared on the Punkhouse EP.

"[5] The guitar lead for "Guest List" was originally written by Vapid for a Sludgeworth song, but it "just wasn't working",[4][10] while the chorus "popped into my head" as he was driving through Roscoe Village in North Center, Chicago shortly before the band went to record the album.