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Why does it hurt? Pain explained

You may be visiting this blog post because you're in pain and want to understand more about it, or because your health care professional has discussed pain with you and you want to further your understanding. This blog post will break down what pain is, what influences it and what you can do about it in a way that hopefully you, the person in pain, can understand.

What is pain?

Pain is a protector of the body. An alarm system of sorts.

Think of when you touch something hot, it hurts, so you withdraw your hand away from it and learn not to touch it again. Pain protects you by changing your behaviour so you can avoid injury or further injury, allowing the body to heal in the meantime. This is pain's function, but most of us incorrectly think that pain is equal to tissue damage.

Infact, pain is NOT an accurate measure of tissue damage. Sometimes, pain is too protective, and gives us unnecessary warning signals.

For example - often people experience pain in a limb after amputation - this is called phantom limb pain e.g. feeling the sensation of a muscle that is no longer there, cramping.

So we used to think that pain worked like this:

1) Nerve endings stimulated

2) Pain is perceived

Simplistically, what we now know is that there are many more steps involved and that pain is modulated by our nervous system:

1) Nerve endings are stimulated

2) Signal sent to our spinal cord via a nerve

3) Message can be transmitted to the brain

4) Brain processes the signal

5) Brain produces PAIN sensation

Even more importantly, different things can interrupt/influence this journey between nerve endings being stimulated and pain being produced.

1) Nerve endings are stimulated

2) Signal sent to our spinal cord via a nerve

Sometimes if there are multiple different types of sensations coming in from around the body, such as touch, vibration and heat - they will 'compete' for transmission to the brain, so the brain's perception of pain could be reduced by multiple sensory signals arriving at the spinal cord at the same time.. this is why HEAT and COLD lotions feel good when we have pain and also why we 'rub something better' when we hurt ourselves.

3) Message can be transmitted to the brain

4) Brain processes the signal

Signals that then do arrive to the brain are interpreted BEFORE giving off any potential pain signals. The signal is put into context with things such as memory (how we have experienced pain in the past), culture, beliefs about pain, anxiety, gender, genetics and the environment we're in to name a few.

5) Brain produces PAIN sensation = we perceive pain

How we can influence pain

With this in mind - what factors have an influence over our pain threshold and perception? We know that stress, lack of sleep, anxiety and depression are all examples of things that decrease our pain threshold - so managing these factors is therefore important when we are managing pain.

Our past experience of pain (memory of it, how quickly that pain got better which might then influence our expectations for what this pain might involve) and our beliefs about what this pain is (fear of the unknown, fear that our body is somehow not strong or that it won't recover) also affect both our perception of pain and actually our PROGNOSIS.

It's important to understand that our bodies are actually very strong and resilient - protective behaviours such as bed rest and stopping exercise actually hinder recovery as we become more fearful and overprotective.

When a pain is not resolving on its own, this is where working with a professional such as an osteopath can help by reintroducing movement, affecting the nervous system through manual therapy, helping you to understand your pain and guiding you through appropriate rehabilitation.

Persistent pain

The longer your body produces pain, the better it gets at producing it - your body actually learns pain. We recommend watching the video below to help 'tame the beast' that is persistent pain:

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