UNDERSTANDING PAIN

What is pain?

Pain is “the unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” – International Association for the Study of Pain  

Through our lived experiences, we each develop unique associations with pain. Pain can vary in severity and be caused by many different things. For example, stubbing your toe on the door frame hurts a lot for a few minutes, whilst persistent/chronic pain can be present in all day-to-day activities.

Where does pain come from?

When an injury occurs, nearby sensory cells detect this damage to the tissue and send nerve impulses relaying this information up the spinal cord and into the brain. The brain then decides what to do with this information. If we imagine detecting pain like an alarm bell, the brain can:

1. Sound the alarm by acknowledging the sensory information and allowing a pain response

Eg. When you touch a hot stove or roll your ankle

1. Silence the alarm by ignoring the pain signal to make you less aware of it

Eg. A dull back ache from sitting for 2 hours in a lecture theatre

1. Turn the volume up loud by recognising the pain signal and increasing the intensity so it becomes disproportionate to the level of sensory input or injury. The alarm then sounds more often and with less input required each time, becoming on-going

Eg. Long-standing back pain or arthritis

https://backtoroots.community/layman-luke-articles/2016/11/8/pain-as-a-metaphorpart-2

Along with different interpretations of pain, there are also different types of pain that can be felt.

Why do certain pains feel different?

1. Nociceptive pain

This pain is felt when tissues get injured or inflamed (such as a rolled ankle)

Usually, this pain is described as an ache which can be sharp with movement  

2. Neuropathic pain

This pain is related to nerves and nervous tissue (such as hitting your ‘funny bone’)

Usually, this pain is described as a stabbing, burning, electric-shock type pain and can be associated with pins and needles or changes in sensation in the arms or legs  

3. Nociplastic pain

This pain is persistent and driven by a sensitised pain system which can be amplified by thoughts, emotions, stress, and a range of lifestyle factors

Usually, this pain is difficult to pin-point and is a general, constant ache (such as lower back pain)

At any time, people can experience one, or a mix of different pain types.   

How can physio help with these pains?

Physiotherapy can be beneficial for managing all different types of pain. Your physio will help to treat the injury through hands-on treatment and a guided rehabilitation process. Through strengthening the area and addressing other contributing factors our goal is to help prevent injuries from reoccurring. As we now know that our brain has a big role in how we perceive pain, physios also provide in-depth education and address your concerns surrounding your condition. The goal of this is to help alleviate feelings of stress or worry and provide you with the confidence to get moving again in a way that feels safe, turning the volume down on those alarm bells.