Not enough time was spent learning about pain during my 3-year Bachelor of Science degree. Unusual, as pain is the biggest reason people come to my clinic. The more I have studied pain, the more I understand its complexity. We could have spent 3 years learning about pain and still have just scratched the surface. Would that have improved my ability to get people out of pain?
Pain can be difficult to get your head around. There are many types of pain and sometimes we just can’t find the answers. This can often leave people feeling incredibly frustrated and not listened to. Poor answers are often given to your questions because the correct answer is unknown.
Pain is common, NORMAL and incredibly important as it’s designed to protect us. It creates memories which hopefully shape our future behaviour. I remember the first time I squeezed a wasp when it was inside of a flower. I learnt quickly to never do that again.
Pain can be related to changes in tissue, where the brain concludes the tissues are under threat and therefore makes us act. It is an excellent, yet unpleasant reaction to what your brain judges to be a threatening situation. If you’re brain doesn’t think you are in danger, then it won’t hurt.
An incredible 20% of people have pain that has persisted for more than 3 months. When pain persists, there is a reason for it. The brain assumes you are in danger and therefore it wants to protect you. As a therapist, the key to success is finding out why the brain has come to this conclusion.
Is there a direct correlation between the amount of pain you are in and tissue damage? No. A paper cut versus an arm being blown off at war. We know what hurts more. Nothing can compare to the pain we experience from a paper cut. Straight up savage.
Additionally, how many of you have been told that a bulging disc is the reason you are in so much pain in your lower back? Hmmm, research tells us that the amount of damage here very rarely relates to the pain we experience.
It is very rare I clinically assume where the pain is coming from in the lower back. More than likely I would be wrong. As mentioned previously, If I can understand why the brain assumes there is danger and thus responds with a pain mechanism, I am more likely able to help reduce pain.
Furthermore, you may experience more pain if there is a lack of understanding from an injury you cannot see. The brain decides whether something hurts or not and is dependent on many factors. Therefore, as therapists, if we can try and find ways to let your brain think there is less of a threat whilst educating you around your injury, we are more likely going to have a positive outcome.
Butler, D.S & Moseley, G.L. (Second edition) 2019, Explain pain, Noigroup publications, Adelaide City West.