Explaining Pain

There are many misunderstandings, myths and unnecessary fears about pain. By understanding your pain, you will have the power to challenge the pain experience and consider new models for viewing what happens during pain. By changing your pain experience, the pain severity may actually reduce.

So what is pain? Pain is an unpleasant experience that alerts you that there is danger. The unpleasantness of the pain is the very thing that makes it so effective and an essential part of living. Once you have pain, it makes you move differently, think differently, and behave differently.

Normally, we think that pain equates to damage, as the body’s defensive mechanism alerting the brain to actual or potential tissue damage, thus we feel the pain, the higher the pain level, the bigger the tissue damage. This is an oversimplified model, yet very often used by healthcare providers.

We believe that all pain experiences are normal and is an adequate response to what the brain judges to be a threatening situation. Sometimes, however, the pain system acts oddly – like a toenail that may not hurt until you notice the blood, or a bruise that you do not remember getting. The pain system can also fail, for example in life-threatening cancers that go undetected for years. The pain system can also malfunction in the opposite direction also, as it does in phantom limb pain patients. An amputee or a child that was born without a limb can experience cramping pain in the limb that they do not have.

It is, therefore, very important to understand that the amount of pain you experience does not necessarily relate to the amount of tissue damage you have sustained.

Pain is subjective, not only to individuals but also to the circumstances, emotional response to the pain and the belief about how this pain will affect you in your daily living. Age, gender, culture, context, emotions, circumstances and many other factors shape your response to pain and your pain experience.

There are many cases that have a substantial problem in a joint or a muscle but your brain does not perceive it to be dangerous so it does not hurt. Similarly, if there is no problem whatsoever in your body, it will still hurt if your brain thinks that you are in danger. This concept may be difficult to accept, especially when you have pain.

Sensory information or cues that comes from the body has to be evaluated by the brain before interpreting it as painful or not. This process is extremely comprehensive; it involves a complex memory, reasoning, emotional processes and consideration of the potential consequences of a response. Thus the context of the pain experience is critical.  Let’s apply an example to this. A minor finger injury will cause more pain to a professional violinist than in a professional dancer, because finger damage posses a greater danger threat to the violinist. This event plays a greater role in the violinist’s livelihood and identity, therefore the pain will be higher.

We also must consider the possibility of secondary gain. As silly as it may sound, but by having chronic pain that gets worse at the time of stress, may actually serve you as the body’s defence mechanism to take rest. This becomes a learnt response and its purpose is to fight fatigue and allow the body to heal properly. Interestingly, people who dislike their working environment will be sick more often if compared to those who love their work. In this case, pain serves them to avoid unpleasant environments, and as long as that environment exists the pain will persist.

To effectively deal with pain, it is important to identify the sensory cues that ignite the pain. Once identified, either eliminate the cues or condition your mind or body against them. Sensory cue that ignite your pain may be a mechanical stress, an unpleasant working environment, fatigue, fear of movement or fear of pain, sense of stress or anxiety or depression.

It can also be a learnt response that was established as a protective response. It is worth mentioning, that your learnt responses may be not your own. Healthcare professionals, your friends and family have a huge impact on how you view your pain. They “inform” you of the significance and the meaning behind the sensory cues, and if they make you believe that your injury poses a threat, then get ready for a long journey of chronic pain and a life of limitations.

Alexandra Z.