What is pain?

Blog

It might seem like a strange question or topic for a blog! Pain is something we have all experienced and know it when we feel it. But in actual fact there’s a little more going on when we feel pain than you might realise.

So, what is pain exactly and what good does it do us?

Pain as our protector (our alarm system)

Pain is a lived experience that is unique to every individual. Fundamentally pain is a good thing – we’ve evolved to experience pain as one of our body’s warning systems against potential threat or damage. The key word here is “potential”. Because pain doesn’t always mean something in our body is broken or torn or damaged.

In fact, pain is an output from the brain. Current pain science tells us that we take in a whole bunch of different information through all of our senses and our brains make a call as to whether there is a credible threat or danger (in which case we will feel pain) or not (in which case we won’t). Our pain experience is sort of like an alarm system that is set to pick up on threats – (like a house alarm going off when a burglar breaks in)

Here’s an example:

You’re running after the ball during a soccer game – you plant your foot and your knee twists inwards. You hear a pop, you feel your knee give way, you hear you team mate call out “are you okay? That didn’t look good”, you see your knee swell up, you touch it and its starting to feel hot – you feel pain. Why? Because your body (all of your senses) is warning you something is not right (you may have torn your ACL). The pain is in your best interest here because its you need to stop and pay it some attention to prevent something further going wrong.

The variable pain experience

There are lots of things that modulate (influence) our pain experience (and these things can change day to day or even hour to hour). Things like how much sleep we’ve had, emotions, relationships, thoughts and beliefs can all influence our pain experience.

In fact, some interesting studies have been done on these modulators of pain for healthy people through things like pressure threshold testing (a way to measure someone’s threshold for mechanical pressure induced pain at any given moment). These studies have shown that pain thresholds decrease (people felt feel pain more easily) when:

· They were shown a red light at the same time the pressure was applied

· They heard a creaking sound played to them

· They dealt with a threatening examiner during testing

· Were sleep deprived

Sensitised alarm systems

Sometimes our warning system gets a bit “out of tune” or sensitised and our brains start interpreting normally safe things as potential threats. This is common in people who have experienced pain for a longer period of time. It’s like the brain gets good at creating pain and is tuned or biased towards threats. So normal everyday safe things are perceived as dangerous and our brain produces more pain. In this situation pain does not mean damage but is actually indicating that we have become sensitised to perceived threats. Its like that house alarm system that now goes off when a mouse runs through the house – it’s become too sensitive.

The pain experience can be influenced

Sensitised alarm systems can be re-tuned. People with persistent pain can reduce their pain experience through education, movement and graded exposure to pain producing activities and experiences. In other words, not only can we adapt to feel pain more readily, we can adapt to be more resilient to pain as well.

Conclusion

Our pain experience is varied and will change based on a variety of factors. In short, the more safe you feel the less likely you’ll feel pain and the more under threat you feel the more likely you’ll experience pain. Understanding what your pain is telling you is an important part of any rehab journey.

Tim Cathers

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