Know Pain, Know Gain

Pain is the number one reason people seek out medical services, but how much do you know about your pain? As a medical community, I believe we are good at describing pain (acute, chronic, burning, aching, the dreaded 0-10 scale, etc), but how good are we at actually helping patients understand their pain? Pain is a subjective experience, meaning each person experiences pain differently. This is probably obvious, but how much thought have you truly given it? Pain has been proven to be impacted by many things including diet, stress, emotional state, physical activity, past experiences, setting, and beliefs. For example, most people would agree that if you sprain your ankle it will hurt, but what if you sprained your ankle while crossing a busy intersection or running from a dangerous animal? Your brain essentially makes a decision very quickly that it does not care about the danger signal from your ankle, because you are about to get hit by a car or become a meal for an animal! Once you get to safety however, the brain will decide that the danger signals from your ankle are now relevant and you will have pain. Another example is how people can have pain in a limb that is no longer there, “phantom limb pain”, and there are even studies showing that you can have pain in a limb that isn’t even yours!

Basically, my point is that pain is much more complex than injured tissues. One of the main concepts that I like to educate my patients on is that pain does not equal tissue damage. Pain is a warning or danger signal, much like an alarm, that something may be wrong within the body. Your brain makes the decision if something should be painful in order for action to be taken. That action could be removing the painful stimulus like a splinter or discontinuing an activity like running or going to your healthcare provider. But what happens if the pain persists after an injury or surgery and lasts months or even years?

When you have persistent pain it can be difficult to get an answer to “why do I have pain?”. Many tests, medications, injections, and potentially surgeries are done with limited relief or explanation. Generally speaking, our bodies will heal itself as best it can in 3-6 months. When pain persists longer than this it is termed chronic pain. This is where the sensitivity of the nervous system comes into play. Many things may actually be responsible for your pain while not causing any real tissue damage, such as applying light pressure to the skin or even prolonged sitting. Sometimes your nervous system or “alarm” can become too sensitive, much like a smoke alarm going off when you’re cooking. One of the main goals in patients with chronic pain is to decrease this sensitivity of the nervous system and re-conceptualize what pain really means. There are many ways to do this, but the first one is education. Here are links to some quick videos that discuss the concepts I mentioned here and more. Please take the time to watch and comment below. If you are interested in hearing more please contact our clinic and I will be more than happy to discuss pain with you or share the multiple resources that I have available!

Lorimer Mosely TEDx Talk

https://www.youtube.com/watch?v=gwd-wLdIHjs

Understanding Pain: What to do about it in less than five minutes?

https://www.youtube.com/watch?v=4b8oB757DKc

– Tyler Patrick, PT, DPT, ATC, CSCS

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