Pain is described as an unpleasant feeling that occurs to protect our bodies. Each and every person feels pain differently, with many different factors which contribute to one’s pain experience.
Before we learn about different strategies to manage our pain, we first need to gain an understanding of how and why we feel pain. As seen below, our bodies detect a change, and send a signal which is interpreted by our brains to determine if we should feel pain. Importantly, these signals do not carry information that specifies if an area is painful or not. Instead, these signals are received by the brain and processed in combination with all other information, to determine if it requires protection and becomes painful. Typically, the signals are sent when the tissue in the body is close to its safe limit and would prevent tissue damage.
IMPORTANT NOTE: In stages 1-2, the signals sent do not contain information about pain and does not cause pain at this stage
What else affects our pain?
Our brains must consider before it decides if it is necessary to protect us by experiencing pain. Some considerations may include ideas surrounding;
- Our previous experiences and expectations surrounding our pain or injury
- Our current mood, level of stress, and beliefs about our pain
- Reduced muscular strength and increased sensitivity of detection systems after injury
- Our fear and avoidance of different movements or activities
- How much our pain has affected you, whether that be regarding stresses with work, at home and our hobbies
How do we manage our pain?
There are many different ways we can approach pain management. As physiotherapists, we aim to create a program specialised for each patient, which teaches you about your pain whilst also providing you with different ways to move again.
In this program, we will:
- Gain an understanding of your pains and provide clarity for questions about pain
- Create a plan that encourages you to achieve goals around your pain and movement
- Increasing your tolerance of movements that can improve your pain experience
- Introduce strategies to help manage a flare-up of your pain: Massage, trigger point therapy, dry needling
- Providing different activities and exercises that will help you with long-term management
- Gradually teach different approaches to increase normal activities in your daily life
Questions to ask ourselves:
- What do we think about our pain?
- Do we always expect our pain to be there? Do we think it’s going to get better? If not, why?
- How has your pain affected your life?
- Has it caused you to stress at work or unable to do your hobbies? Has it affected your relationships with other people?
- How has it changed the way you moved? Do we avoid moving because of the pain?
References
Colvin, Lesley, and Marie Fallon. 2012. ABC of pain (Wiley-Blackwell/BMJ: Chichester, West Sussex ;).
Fisher, Keren, and Susan Childs. 2017. The Practical Pain Management Handbook : The Essential Evidence-Based Guide (Taylor & Francis Group: Milton).
Miller, Clint T., Patrick J. Owen, Christian A. Than, Jake Ball, Kate Sadler, Alessandro Piedimonte, Fabrizio Benedetti, and Daniel L. Belavy. 2021. ‘Attempting to Separate Placebo Effects from Exercise in Chronic Pain: A Systematic Review and Meta-analysis’, Sports medicine (Auckland), 52: 789-816.
Siddall, Benjamin, Adrian Ram, Matthew D. Jones, John Booth, Diana Perriman, and Simon J. Summers. 2022. ‘Short-term impact of combining pain neuroscience education with exercise for chronic musculoskeletal pain: A systematic review and meta-analysis’, Pain (Amsterdam), 163: E20-E30.
Van Griensven, Hubert, Jenny Strong, Anita M. Unruh, and Ronald Melzack. 2013. Pain : a textbook for health professionals (Elsevier Health Sciences UK: London).
