What is pain?

I will likely begin some of these entries with a disclaimer. The following post will focus on physical pain and introduce how emotions/psychology are related to the pain process. This is not an exhaustive definition, but simply provides the basics. Websites are included if you would like to do additional research.

When ever I first meet a new client, I always ask them to tell me their pain history. I often hear things like, “I began to experience a burning sensation in my feet” or “It felt like someone was stabbing me in the back.” Achy, stabbing, shooting, sore, sharp, hot, constant, tingling, and numb are just a few descriptors that I hear daily. Pain is complex! So, what is pain?

On the Stanford Medicine website, they write, “The International Association for the Study of Pain (IASP) defines pain as, ‘An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.’ Pain is a subjective experience in which there is no method for determining if an individual is in pain. Every person experiences chronic pain in a different way which makes it difficult to treat.” (https://med.stanford.edu/pain/about-chronic-pain.html

The Mayo Clinic offers a lot of information on pain, including definitions of acute vs. chronic, causes of pain, an explanation of the pain pathway, and other influences on pain. On the pain pathway, they wrote, “In your spinal cord, specialized nerve cells filter and prioritize messages from the peripheral nerves. These nerve cells act like gates, controlling which messages get through to your brain — and at what speed and strength. Severe pain, as from a burn, is processed as an urgent warning, triggering your muscles to pull your hand away from the stove. Some pain messages, such as from a scratch or an upset stomach, are relayed more slowly or with less strength.

From the spinal cord, pain messages travel to the brain. Your brain responds by sending back messages that promote the healing process. For example, the brain can signal your autonomic nervous system, which controls blood flow, to send additional white blood cells and platelets to help repair tissue at an injury site. Your brain can also signal the release of pain-suppressing chemicals.”

transmission_of_pain

(Photo from: http://www.change-pain.com/grt-change-pain-portal/change_pain_home/chronic_pain/physician/physician_tools/picture_library/en_EN/312500026.jsp)

There are so many interesting complexities about pain. For example, the Mayo Clinic notes that individuals can experience the same injury but have completely different pain levels. I break my toe and you break your toe, but I give it a pain rating of 9 and you rate it as a 6. Why is that? I love how the Mayo Clinic explains it, “A person’s response to pain is heavily influenced by many individual traits, as well as psychological, emotional and social factors.

When pain messages reach your brain, they pass through the emotional and thinking regions, as well as the physical sensation region. A person’s experience of pain is shaped by the complex emotional and cognitive processing that accompanies the physical damage or sensation. So pain really is in your head as well as your body.”

So, the take-home message is this: pain is complicated. Scientists and medical providers understand the underlying mechanism of pain, but because there are so many components to pain, it can make it very difficult to treat (especially chronic pain).

I hope this was a helpful brief intro to the world of pain.

Till next time,

Yvonne