What is Pain?

So what is pain? Why do we have to experience it? 

Pain is a very real experience, produced by the brain, that is one way for our body to communicate with us. Pain has many contributing factors, different from what one used to believe. We used to follow a more specific model for pain, which meant that pain came from muscle and tissue damage. While tissue/muscle/joint injury does play a role, it is not the only contributing factor.

We now know that a biopsychosocial approach to treating and addressing pain is best. This means there is a biological component (i.e. tissue damage), psychological component (i.e. fear of performing certain movements, our emotional state as an influencing aspect), and social component. The ability to experience pain is actually a good thing to have- It is a way for our brain to communicate to us that something is wrong and serves as a protective device. For example, if you step on a nail, the high level of pain that our brain expresses tells us we need to stop walking, rest our foot, and not walk on an injured leg. Think of it as an alarm, alerting us to irritating movements and positions, trauma, and the potential for injury.

There are two major types of pain: Acute and Chronic. Acute pain  is common with tissue/bone/joint/muscle damage, which can last from hours to ~ 3 months. With chronic pain, structural damage is often not the main issue, but rather it is more about the sensitivity of the nervous system.

The issue that arises with chronic brain is  a brain that continues to recognize a threat, and continues to produce pain signals to your body. This results in a decreased pain threshold. So to think about the alarm system, our alarm goes off easier when we are in chronic pain.

What can influence our pain experience is many things, such as stress, nutrition, genetics, habits, alcohol consumption, past experiences, sleep, and tissue/joint injury. Positive mood and negative mood states can also influence our pain levels. Addressing pain from a multimodal approach is crucial to truly treating pain, particularly chronic pain. If one can improve the sensitivity of the nervous system and improve our pain threshold, the more resilient we can be to pain.

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No pain, no gain. Right?

This has been a phrase tossed through the fitness industry. Please know there is a difference between muscle burn, and true pain. Pushing through pain, particularly if the pain continues or increases, is likely only going to make things worse. Rather, exercise and move to just before the painful ranges of motion. This may also help your body see this movement as less of a threat, and allow you more range to work with.

What’s the best way to address pain?

  • Relaxation and breathing techniques

  • Progressive loading exercises within pain-free tolerance

  • Identifying areas that are affecting our pain experience (i.e. diet, sleep, stress, alcohol, habits, past experiences, tissue injury)

  • See a qualified professional for a detailed assessment of these factors and get you onto an individualized plan!

The goal of this blog post is to gain a better initial understanding of what pain is. But please know, even “experts” in pain still have so much to learn. Neuroscience is an ever changing field that we are learning more and more about. Understanding the fundamentals behind why pain occurs and exists is an essential step on building a more resilient self!

References

Louw, A., Nijs, J., & Puentedura, E. J. (2017). A clinical perspective on a pain neuroscience education approach to manual therapy. The Journal of manual & manipulative therapy, 25(3), 160–168. https://doi.org/10.1080/10669817.2017.1323699

Peciña, M., Karp, J.F., Mathew, S. et al. Endogenous opioid system dysregulation in depression: implications for new therapeutic approaches. Mol Psychiatry 24, 576–587 (2019). https://doi.org/10.1038/s41380-018-0117-2

Parker, R., & Madden, V. J. (2020). State of the art: What have the pain sciences brought to physiotherapy?. The South African journal of physiotherapy, 76(1), 1390. https://doi.org/10.4102/sajp.v76i1.1390

Sjörs, A., Larsson, B., Dahlman, J., Falkmer, T., & Gerdle, B. (2009). Physiological responses to low-force work and psychosocial stress in women with chronic trapezius myalgia. BMC musculoskeletal disorders, 10, 63. https://doi.org/10.1186/1471-2474-10-63

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