Pain > Can we trust our pain?
Can we trust our pain?
As we have just discussed, it is possible for our brain to use pain as a response to actual damage in the body, or to a perceived threat of damage. Feeling pain does not always mean there is damage happening to our body; only that our brain thinks there might be a potential danger. Pain is helpful as it protects us. It makes us seek help when needed, and stops us from making minor injuries into serious injuries.
Unfortunately, as with many complex systems in our body, our pain alarm system may become too highly sensitised. Perhaps it might use pain to warn us of danger when the activity is actually completely safe. Or it might continue to warn us of danger long after the risk has passed. When this happens it is sometimes given the name “chronic pain”.
How do I know if I have chronic pain?
Pain that persists
The term chronic pain is used to describe pain that persists beyond the typical time in which our body heals an injury. This is usually estimated to be 3-4 months after the initial injury episode. There are some other features which are characteristic of chronic pain, which may help us determine if that is what we are dealing with:
Pain that comes on or worsens for no clear reason
In the early stages after an injury, pain tends to be quite predictable. When we move in a certain way, it hurts, and when we stop moving the pain gets less. This type of predictable pain pattern is sometimes called ‘mechanical pain’. If our pain is ‘non-mechanical’, it may come on or flare up when we are sitting and resting, or when we are lying in bed at night. This is more likely to occur as acute injury pain transitions into chronic pain.
Pain that is made worse by non-physical factors
Any pain can be made worse by a range of factors that have nothing to do with movement, but this is especially true of chronic pain. These factors may include:
Being under lots of stress
Not getting enough sleep
Fighting off a virus
What we are thinking about
Our mood
The context or environment we are in
The people around us
What we are told about our injury or pain situation
Our mental health and general physical health
What scans have shown about our painful area
Pain that is hard to define or seems to spread to other areas
This is one characteristic feature of chronic pain that may cause us great concern – it can feel as though our problem is getting worse, or as though we have injured a different body part. Actually, it is just because of changes that occur within the ‘alarm system’ circuitry of our nerves and our brain when we have pain for a long time.
Pain that is out of proportion to the trigger
Perhaps the most common story from a person with a chronic low back pain problem is: “I was just bending down to tie my shoelaces!” Wherever the pain problem is, it is more likely to be triggered or flared up by seemingly harmless activity as it becomes a chronic pain problem. Some people with chronic pain start to feel pain in response to other sensations which seem harmless, such as strong smells, wind blowing past the painful body part, a loud noise, or soft clothes brushing against your skin. Our common sense and life experience tell us that these things cannot possibly cause any damage to our body, but if we have chronic pain, these safe things can be cause very real pain. This happens when our alarm system, trying very hard to protect us from the perceived risk of re-injury, becomes too sensitive and over-protective.
In summary, our pain cannot always be trusted to be a good guide as to the presence or severity of actual injury or damage. Pain is a complex tool that our brain and nerves are using to try to protect us, and our pain is under no obligation to seem appropriate, proportionate or reasonable!
