Understanding Pain
Pain is one of the most common symptoms that lead a person to seek the help of a physical therapist or other health care professional. Physical therapists are experts in the management of pain.
Successful management of pain relies on an understanding of why someone feels pain. Although much is still being discovered about the sensation of pain, our understanding of how and why pain exists has changed over the past several decades.
A New Understanding of Pain
Pain was once thought to be an indicator of injury to body tissue; it is now known that pain also can be a warning signal designed to alert us to potential damage and to protect us from injury. As a result of this new understanding, we now know that feeling pain does not necessarily mean a physical injury has occurred.
When a tissue is injured or the potential for injury occurs (such as with an ankle sprain), special nerves called nociceptors send information toward the brain to warn of damage. The body responds in order to minimize damage (ie, sends pain signals to make sure the person doesn’t step on the affected foot), and to begin the healing process (ie, produces swelling to bring healing cells to the area).
However, we now know that injury-warning pain signals can increase or decrease based on specific situations. For example, if you sprain your ankle while trying to get out of a burning building, you may not be aware of your injury until you are safe, because the warning signals are overridden for a more important reason: survival. Science has shown that this decision to rank the importance of warning signals occurs in the brain, which has led to the conclusion that the sensation of pain is triggered by, and occurs in, the brain.
Science has also shown that no two human brains are alike. Therefore, it follows that each person’s pain experience will be unique—influenced by specific situations such as the one described above, as well as by a range of other factors that make each person’s life unique. These factors can include life experiences over time, psychological histories, living and work environments, and even the social structures in which we live. These past experiences can help to decrease pain in life-threatening situations, but can also increase pain in people with persistent or chronic pain.
Major Implications for Pain Management
The recent shift in the understanding of pain has several major implications. First, it changes the way a physical therapist may approach your care. In the past, many health care fields focused treatment on the healing of damaged tissue. Although this approach helped many people who had experienced an injury, others reported pain that lasted well beyond the time necessary for tissue to heal.
Based on the new evidence regarding pain, physical therapists are today using methods of treatment and of managing pain that do not solely focus on injured tissue, but also address other factors such as environment, stress, psychology, and social considerations that may be influencing the amount of pain experienced. This “brain and body” approach to the management of pain is an important shift that has occurred in response to the new and evolving understanding of the purpose and nature of pain.
Pain and Opioids
The misuse of opioids has become a public health emergency in the United States and beyond. The origins of the current crisis date back to the late 1990s, when the medical community had no evidence of the addictive properties of opioid-based pain-relief medications. As medical providers began to prescribe opioids more frequently, because they successfully eased pain in many patients, evidence of addiction began to surface.
In response to the crisis, measures including better addiction prevention, treatment, and recovery services, better data, better pain management, better targeting of overdose-reversing drugs, and better research have been implemented. The crisis will likely have its solution in new approaches to the treatment and management of pain. Physical therapy is proving to be one of the safest methods of treating and managing pain.
For more resources on pain, and on the use of opioids for pain management, visit this website’s Health Center on Pain and our Health Center on Avoiding Opioid Use for Pain Management.
How Does it Feel?
We often use different terms to describe pain, such as sharp, burning, stabbing, or aching, but it is hard to know if you feel pain the same way your friends or family feel it. Not only is your experience of pain unique to you, it can change from day to day and situation to situation. Research shows that pain can be modified and can change for a number of reasons.
The latest science tells us 2 important facts:
- The amount or intensity of the pain you feel is not an indication of the amount or seriousness of a possible injury. In fact, there may be no injury present.
- The experience of pain can change; the pain felt today does not necessarily have to be the pain felt tomorrow.
How is Pain Science Education Used In The Clinic?
Pain science education is more than just information on the neurobiology and neurophysiology of pain passed along throughout your treatment sessions. In the field of physical therapy it has become synonymous with how the therapist listens, interacts, and talks with the patient…forming trust, relationship, and alliance. It also represents an effort to describe injuries and chronic pain in a more honest way, with the focus being on overall changes in how our brain and tissues interpret these pain “sensations” instead of older models that teach patients that the amount of pain they are in varies in intensity with how much “tissue damage” there is.
It may sound funny at first, but this information and behavior added into your therapy can be a strong foundation for a chronic pain patient to regain confidence in their body’s potential for movement and healing.
Contact us today at ClearCut ORTHO in Fort Worth, TX for a free consultation and let us help you move on from stubborn pain symptoms.
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