Pain is defined as
“ a sensory and emotional experience based on actual or potential tissue damage”
We all know pain and have experienced some or other form of pain (unless you have a very rare and debilitating condition where you cannot feel pain). This is a multi-billion rand industry and there is no place in the world where it does not reach. This is my day job, and here I want to talk about the the side of pain we may not fully understand, how we process pain. Now, I am not speaking about simple injuries here, pain from a source that you understand the cause you can manage. Here I am talking about the more illusive pain, the types that you cannot figure out easily or feels worse without a known cause.
This definition of pain is the best I have found. Science has evolved so much in the last few decades and our understanding pain with it. A very outdated understanding of pain revolves around the concept on nociception - that a nerve is activated and sends a message of pain to the brain. This is unfortunately grossly inadequate and inaccurate. I am going to try simplify a complex concept as best I can, but there is a lot of additional resources in the links below.
Our body experiences a variety of sensations, all the time. Sensation is not pain, it is an experience that begins at out nerve endings, travel to the brain and is interpreted. The complexity happens in the brain. Our brain receives an incomprehensible amount of information every second and has a filtering system to determine what is important and what is not, at the time. This is what happens when we are in, as an example, a life threatening situation (like a war) and our brain ignores stimulus that would normally cause great pain, (like a gun shot), in order for us to get out of harms way. This a common retelling of historical war accounts from survivors who did not know they had an injury until after they where safe. Likewise, but in reverse, we can experience extreme pain with minimal stimulus when our brain interprets a threat to be severe or extreme.
This proves that the brain is central to our experience of pain. Pain is associated with fear. The greater perceived threat or damage, the greater the perceived experience of pain, likewise, the lessor the perceived threat or tissue damage, the less the pain experience.
I cannot emphasise enough how valuable this information is. What it means to me, as a therapist, is that if I can explain and educate my clients on their injury, help them understand what and why they are feeling what they are feeling, I can help shape the experience of pain in the brain. This is not just about me, and what I can do with this information. This is about you - and what you can do when you have pain.
Pain is ultimately a warning that something is wrong, and you need to heed that warning. When you are trying to understand if your pain is serious or of concern, when in doubt, please see your Doctor.
Tips on how to understand your experience of pain:
Pain is associated with fear, so ask yourself, what are you most afraid of in regards to the pain, is your pain aggravated by what you fear? My experience indicates common fears include loss of income or work, fears of serious/terminal medical illness, fear of being impaired from participating in something meaningful or important - are just three.
Is you pain associated with a past experience or that of a friend of family member? These experiences can heighten our perception. Our memories do affect our experiences, both positive and negative.
How much do you have to loose or gain from this pain or injury? I know this sounds perhaps odd, but it is really down to human behaviour. It is well understood that if a person benefits from and injury being more severe, the experience of pain may be increased too (for instance with financial gain), likewise, a pain experience may decrease if a person has more to loose.
Our childhood experiences around pain, how we managed it and how our parents or caregivers reacted towards it (both towards the child and there own pain or injury) has influence over our experience. This psychological element helps form context to our experience.
Our emotional state at the time has a considerable impact on our experience of pain. Pain has a long history associated with anxiety and depression. This is multifactorial. Our nervous system is in a heightened state with increased anxiety, meaning we feel more sensitive to everything, including sensation or pain. Beyond that, our emotional state is strongly correlated to our feeling of pain, for instance, chronic or long term pain is commonly associated with depression and seldom do we complain of pain when we are very happy or positively excited.
So this a very general and broad overview, but can give us insight into our reaction or experience to pain. Seldom are these considerations a cause, but rather help us understand the whole experience. It can also be very helpful to decrease our experience of pain, by understanding what the context and is aggravating our experience, or making it worse, we can help manage, reason and work on what is making it feel that way.
Knowledge is power. By having better information, we lesson our fear and anxiety. Likewise, as many healthcare practitioners know all too well, poor information or sources, like Dr Google (limited searches and poor context), can increase our fear and anxiety and increase our pain experience.
Comments