Explain Pain: Part 2

Thoughts today continue with the ‘explain pain’ topic that I started some time ago  (apologies for the delay), so let’s look further at this.

There is a well experienced but less well-understood body phenomenon that affects each and every one of us, in an infinite number of ways and more or less at various points in our lives.

Brief recap:

In Part One I considered the following points:

PAIN…

1. … is normal, personal and always real
2. does not have sensors; we have danger sensors only
3. … and tissue (body) damage rarely relate
4. … depends on the balance of danger and safety
5. … involves distributed brain activity

(What follows by the way is completely understandable even if you haven’t read part one!)

Pain is an INTANGIBLE EXPERIENCE and ONE PERSONS IS NEVER THE SAME AS THE NEXT. I’m sure that we can all recall times when we’ve wondered why someone appears to be suffering over ‘nothing’.

Thanks to science, technology, research and the time devotion of clever people, there is constant improvement in our understanding of pain.

Very importantly, this means that lowly health professionals like myself can take on board the clever people’s findings and present a (hopefully) coherent picture of this slippery, abstract subject. There’s still a long way to go but even a little clarity on the reasons behind our own personal experience can help ensure that we are better able to cope.

Explain Pain: Part 2

Context: how not to explain dodgy intervertebral discs…

6. Pain relies on context

It can be influenced by the things you see, hear, smell, taste and touch, things you say, things you think and believe, things you do, places you go, people in your life and things happening to your body.

Remember that pain is ‘normal, personal and always real’; this point helps explain why we all experience it so differently – everyone has a different context. We can probably all think of times when something has hurt more than it might usually, such as when we’re stressed or upset and when an already painful body part makes a second one seem more (or less?) uncomfortable.

As a Physiotherapist I always think carefully when explaining someone’s pain to them; giving unintended context can influence a persons experience.

7. Pain is one of many protective outputs

Lots of body systems

When threatened, the body is capable of bringing many protective systems online, including:

• IMMUNE – attacks the invaders that try to bring infections and disease on-board
• RESPIRATORY – oxygen in, carbon dioxide out
• ENDOCRINE – glands, situated in various parts of the body, that produce hormones to regulate… things
• MOTOR – movement
• AUTONOMIC – part of the nervous system that influences our internal organs and affects digestion, heart rate, blood vessels, coughing, fight-or-flight response, amongst others
• COGNITIVE – knowing, understanding, judging, problem solving….
• EMOTIONAL – regulated by our limbic system which is also responsible for behaviour, motivation and memory
• PAIN

8. We are Bioplastic

While all protection systems can be dialed up, the notion of bioplasticity (that the form of something can be altered, changed and reformed) suggests that they can also be DIALLED DOWN.

As the context changes (which it will do – nothing happening around us or acting upon us remains static) and as the response(s) of our protective systems change, pain will correspondingly change.

9. Learning about pain is therapy

If you better understand WHY you hurt, it helps you hurt LESS.

If you have a pain problem you are not alone: millions of other people will be experiencing pain at the same time as you. As an example, chronic pain (continual pain lasting for more than three months) affects between one-third and one-half of the UK adult population, or around 28 million people (source).

10. Active treatment strategies promote recovery

If you better understand WHY you hurt then you can make plans and devise strategies for HOW TO HURT LESS.

There are many ‘treatment’ options available and the ones that work best will be unique to the individual.

Common pain-reducing actions include devising new and better ways to move (plug: Physiotherapy can play a big role here!) improving fitness, eating more healthily, sleeping better, optimising medication and/or seeing a counsellor/psychotherapist.

As an overarching concept, if you can positively influence the things you:

DO
SAY
THINK
BELIEVE
PLACES YOU GO
PEOPLE YOU SEE
THINGS HAPPENING IN YOUR BODY
WHAT YOU EXPOSE YOUR SENSES TO

then you can positively affect your pain experience and begin to dial it down.