With pain comes resistance, from our mind and our bodies, because pain is uncomfortable, it hurts and frankly it absolutely sucks (I’m sure we can all agree). It’s personal, complex and relates into our social, psychological and biological aspects of health.
What is your relationship with pain? What is your understanding and beliefs around it?
Our awareness and connection with pain is always evolving and in order to treat it we need to understand it. So, let me explain pain and put to bed your misunderstandings and fears;
PAIN IS NORMAL AND REAL
Pain is the most powerful, intricate protection we have and even though we cannot see pain, it is a very real sensation that everyone feels. It is unpredictable and with unpredictability comes fear. It is a normal response and you only become aware of it when your brain perceives anything as a threat.
IT RELIES ON CONTEXT
Identifying cues and context is important in understanding a pain experience. Damage to tissue, your beliefs, avoidance of movement due to fear, inactivity, emotion and coping strategies all play a part and can determine how your body responds.
Take a writer with a deadline and a soccer player having the same hand injury.
No matter how minor, the professional writer will experience more pain with the same hand injury as a soccer player because the damage is perceived as a greater threat. How?
A soccer player doesn’t really need to use their hands while playing, yes to push off opponents, pick up the ball for a throw in or to give the referee the bird when they make a poor call, but its not vital or important in their profession. A writer however, with a deadline (added stress) and the same injury is considered a major threat to the body. Hands down its of higher importance, therefore pain is heightened.
THANK YOUR ALARM SYSTEM
“Detects changes that are big enough to be dangerous”.
Our brain is warned of risk through our sensory system detecting changes in our body, they work hand in hand and are designed to protect us for doing damage. Butler & Moseley talk about your remarkable danger alarm system being of significant importance and there to help you escape trouble.
Sometimes, our alarm system can be faulty (e.g. people with diabetes) and even in situations where there is danger, pain is not present to warn you. So, don’t take it for granted, start shifting your mindset and awareness of pain and be grateful its working to teach, protect and inform you.
IT HAPPENS IN OUR BRAIN
Our brain is our command centre and controls the information coming in and responses going out (pain). It decides on how much protection we need, the amount of danger we are in and the nature of danger.
“The brain has to decide whether pain is the best thing for you at the moment.”
ACUTE V CHRONIC
Acute pain may last for as little as a few moments or up to three months and resolves once the cause of pain has healed. It encourages the healing response and protection of damaged tissue.
Once we pass the three months, we start to hit a chronic phase. Which persists beyond the normal healing time of an injury/disease and has no foreseeable end point. With persistent pain comes a more vulnerable alarm system. Our responses, thoughts and beliefs begin to contribute to the problem as they are hypersensitive.
“When pain persists and feels like it is ruining your life, it is difficult to see how it can be serving any useful purpose. But even when pain is chronic and nasty, it hurts because the brain has concluded, for some reason or another, that you are threatened and in danger and need protecting- the trick is finding out why the brain has come to this conclusion.”
THE MEASURE OF DAMAGE SOMETIMES DOESN’T MATCH THE PAIN
Pain is so complicated, maybe even more so than your relationship status. I’m sure you’ve heard stories where shark attack victims sustain significant injury but have reported little to no pain. In a moment your brain is weighing up many factors including your environment and it concludes if putting you in survival mode is better than inducing severe pain, that’s it’s protection. Amazing! But wait, how can someone experiencing significant tissue damage
feel no pain and I’m over here crying from a simple paper cut? Because “the amount of pain you experience does not necessarily relate to the amount of tissue damage you have sustained”.
THE FEAR AVOIDANCE MODEL
“Sometimes the fear of pain is more disabling than pain itself.”
Fear is an unpleasant emotion caused by the threat of danger, pain or harm. Fear keeps us safe, protects us from danger and instigates our defensive responses. It can be good and also bad for us. By bad I mean we can find ourselves getting caught in an endless loop of:
Injury → Pain experience → Fear → Nervousness/ apprehension with movement → Reduced confidence/ independence → Avoidance → Increased/ misinterpreted pain → Pain experience (repeat)
This is the general process we see, but don’t allow your negative thoughts and fears to lower your pain experience threshold.
There is a fork in the road and the grass is really greener on the other side. This “opportunity bypass” is your road to recovery combining knowledge, pacing, understanding confrontation and reducing fear to improve your wellbeing and getting you out of the loop.
You are in the driver’s seat, so check in with yourself regularly and ask yourself how you are travelling. You are the owner of your pain and at the end of the day you have control on what to do and the steps you want to take.
Be brave in accepting your current state and be courageous in being aware of the signals and cues your body is trying to show you.
Remind yourself of two things: (1) your brain wants to protect you from anything it concludes is dangerous, and (2) in persistent pain, your danger alarm system becomes very hypersensitive and even when something poses no actual threat, due to the delicate state your body is in, your brain alerts you of significant danger and responds with consistent pain. Be active in your coping style with pain and make a positive change.