Pain is crucial to realising what is good for your overall health. Pain is an unpleasant experience that helps to keep you alive by alerting to actual or potential bodily harm. It warns you when something might be wrong and gives you an opportunity to change or modify what you're doing to prevent further injury. However, pain is complex, and many other factors influence it.
Much of what we used to believe about pain was from a book that was first published in 1644, pain was simply a sensory experience to alert the nervous system, it was something that existed independent to the brain. In an ideal world it would be wonderful if pain only worked this way and you could just stop doing the thing that was hurting you and the pain would go away. However, we've come a long way in understanding the science of pain. It is not always a simple alarm system, alerting you about what could be dangerous, if you think about activities that should create pain, like a contortionist bending their body in unnatural ways, they are obviously not in pain, for them, the contortion simply isn't painful. In contrast pain can exist when nothing dangerous is happening to the body at all, like sitting working on a computer.
This new understanding of pain comes from several studies, for example, phantom limb pain, a phenomenon which up to 85% of people who have lost to limb experience; pain in the absent part of their body. These studies started to explain just how complex pain can be, the fact that there are no messages travelling from the limb to the brain because there simply isn't a limb there to experience it in the first place. Further studies demonstrated the role the mind plays in the physical experience of pain, there are cases where an MRI or X-ray shows evidence of injury but the person feels no pain, various studies show patients without any pain were given imaging and 30 to 80% of them had a bulging vertebral disc, 34% had a rotator cuff tear and 30% had meniscus degeneration but they simply didn't have pain normally associated with those issues. In contrast to this, some people experience pain but there's no concrete injury or degeneration shown in an MRI that indicates the pain should be there in the first place.
With a new understanding of the brain's role in pain, we understand that pain is a complex experience shaped by our thoughts, our emotions, our beliefs, our memories, our stress levels, the sensations we feel, the visual information we take in and so on, rather than simply being a message sent from the physical body. Lots of people have pain that is largely due to high stress, poor mental health, lack of sleep and other similar factors but simply listing factors isn't helpful, you need to understand how these factors influence pain and more importantly how you treat them. To sum up, your brain feels 100% of the pain you feel but that said “the pain comes from the brain” is often misinterpreted as “the pain is all in your head” that's not the case, the pain is created by the brain but it is not a figment of your imagination, each person's pain experience is real and unique and to understand why we must delve deeper into how pain works.
So, the factors in pain split into three:
Biological
The pain could be linked to a mechanical problem with biological tissue, e.g. after an injury.
Psychological
The pain can be a manifestation of your thoughts your emotions, your beliefs they could be tied to stressful events, they might be tied to understandings and emotions you have about that pain.
Social
How you are supported, your relationships, the people around you whilst you convalesce after injury or illness. Loneliness, for example, is a big factor with people with pain, people who lack social engagement, experience pain more intensely. So when treating pain, you have to look at how your mind, body & environment contribute to your sense of pain.
Different types of pain
Acute pain which normally begins suddenly after an injury, it will then go then improve as the body heals, which is normally around about the 12 weeks.
Chronic pain is less predictable, it persists beyond the normal healing time, therefore lasting longer than 12 weeks, the symptoms might be linked to the environment, unhealthy workplace or conditions, lifestyle, poor sleep and diet or psychology (excessive stress or depression) to treat chronic pain and keep it from coming back you have to have a rehab plan and you also need to address the other factors causing the pain.
I often joke that having a client with chronic pain arrive for treatment and me asking them, if they've "tried mindfulness and breathing" to solve their pain, I probably deserve to be punched in the face for a complete lack of understanding. However having an open mind about how you experience pain and the solutions to help, is the first step into experiencing a different life going forward.
I work with clients to help address how they experience pain, to look for positive solutions going forward and to try and decrease their reliance on pain medication an increase the overall well-being.
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