What Is Pain?
Pain is the reason you’ve found your way to this article, and while each of us may have a different reason for being here, it’s likely that we share some common experiences when it comes to pain. We know how it makes us feel, how it affects our relationships and our lives, and how much we wish it would go away.
But what most of us don’t know is why we have pain in the first place, or what we can do about it.
Pain sucks. Point blank.
Sometimes it's just an annoyance, other times it is crippling and keeps you from doing the things you love. You are not alone. There are millions of people in the US alone that suffer from chronic pain. Unfortunately, many people don't understand what pain is or how it works.
If you are suffering from chronic pain there’s a good chance you have had your experience related to the Biomedical model of pain. The Biomedical model suggests that there is a direct link between tissue damage (or other body processes) and the experience of pain. Basically, iIf something hurts, this model suggests that there must be something wrong with the body - an injury, for example - which needs to be “fixed”.
However, for many people with chronic pain, biomedical explanations fall short in explaining their experience of pain. For example, biomedical models cannot explain why some people develop persistent pain after relatively minor injuries while others recover normally; they can’t explain why two people with similar injuries may experience different levels of pain; and they can’t explain why people suffer from pain months, or even years after said pain would be considered useful.
Understanding how pain works can help you deal with it more effectively. If you're suffering from chronic pain, knowing about the mechanisms your body uses to keep you in discomfort can help you manage and reduce it. There is a lot to unpack, but we can start small: Here are three things to know about pain:
#1: Pain is multidimensional
We mentioned the Biomedical model of pain above. While this has certainly been useful in the case of acute injuries, the last few decades of emerging research has shown us that pain is multidimensional and biopsychosocial, meaning that biological, psychological (thoughts, emotions, and behaviors), and social factors all play important roles in each individual’s unique experience of pain.
Pain can be influenced by a number of contextual factors — including your beliefs about pain, your mood, past trauma, and societal things like the stigma associated with certain kinds of pain (i.e., depression or chronic illness), as well as isolation that may occur when you are in pain and can’t socialize as you normally would.
Hell, even access to healthcare, or lack thereof, can influence pain. I’m not kidding.
This means that the context in which the pain occurs has a big impact on how we perceive it. For example, experiencing an injury while playing sports might have less of an impact on an athlete’s life than if the same injury occurred during everyday activities.
But perhaps most importantly: Pain is not always an indicator of tissue damage. In fact, the research shows that pain is POORLY correlated with tissue damage. It could be due to many other factors as mentioned above. That's why if you experience chronic pain — defined as lasting three months or longer — it's important to consider all of the potential underlying causes, because there is almost a 100% chance that it isn’t related to tissue damage.
#2: Pain is a very important alarm system that your brain uses to alert you of potential danger.
Pain isn’t necessarily a bad thing. Most of the time it is there to protect you.
If you touch a hot stove, for example, pain is the signal that tells you to quickly pull your hand away. You’re safe (relative to how long you touched the stove) AND you learned a lesson. This is a win. In rare cases, some people are actually born with a condition called Congenital Insensitivity to Pain and Anhydrosis (CIPA), that inhibits their ability to feel pain. While it might sound cool, imagine if you drank scalding liquid and didn’t notice, or touched a hot iron and didn’t notice. These people accumulate tons of injuries and bodily damage and statistically don’t live over the age of 25.
Pain is important.
Think of pain like an alarm system. Dr. Greg Lehman uses the analogy of a smoke alarm that one would have in their home. A smoke alarm is great for detecting a potential fire, but smoke alarms can also go off for all sorts of reasons NOT related to a fire:
The alarm could be low on batteries.
The alarm could be detecting smoke that isn’t (yet) a fire.
The alarm could be malfunctioning.
Case in point: When I was a kid, we had a smoke alarm installed in a very poor location in the hallway outside of our bathroom. We all loved taking hot showers, and when we opened the bathroom door, and released all that steam, the alarm would go nuts.
Fire? Nope. Water vapor. Probably the farthest from fire you can get, but that didn’t stop the alarm from piercing our eardrums.
Pain is a very important alarm system that your brain uses to alert you of danger..but it isn’t always foolproof. At the end of the day, your brain is taking all of the information it has, predicting a few things (because it can’t process ALL sensory information), running that against previous experiences and maps, and making the decision to send a pain signal based on its OPINION of the state of your body.
The brain really means well. It’s trying to help you. It just doesn’t always make that feel good to you.
#3: You can be in pain, and be managing it, and still keep doing the things you enjoy.
Motion. Is. Lotion.
Say it out loud. Remember it. This is important.
As both a Licensed Massage Therapist and Certified Strength and Conditioning coach, something that annoys me is there is still this misconception that the best course of action for pain is immobilization or rest. Sure, if something is acutely broken or torn, rest is needed, but even in the context of injuries, we now know that immobilization is almost always a bad idea.
Persisting in activities you love isn’t necessarily going to cause more harm. Remember, in the majority of cases of chronic pain, tissue damage is NOT the issue. In chronic pain, PAIN is the issue!
I could probably write an entire article about habituation, but for the sake of brevity here, consider this: the body has the ability to adapt to stress. For both mental and physical reasons, movement is medicine. Not only does strength and mobility help you to learn to tolerate higher degrees of pain, but it also helps you to think of yourself as strong, which helps with the contextual factors associated with pain. Also, many folks engage in activities and athletics that are social in nature, which also aids in pain management.
When you have pain or injury it is most likely best to get moving again, start exercising or resume your hobbies. Sure, you may have to modify your activities to accommodate your pain, but that is all part of the journey.
Wrapping it up…
This article is just a small slice of information on pain. The reality is this is a complex topic that needs to be viewed from multiple angles. As such, consider this just an introduction, and in subsequent articles we are going to dive a bit deeper into the topic, to get a feel for how pain works, how it affects us, and how we can ultimately manage it and still feel and perform our best.