In this article osteopath and clinic director James Clapham
shares his insight and expertise on pain in this snapshot introduction to
explain pain.
Pain, it’s something that everyone can suffer with at some
point in their life, possibly daily maybe rarely. Whatever the case it is an
inevitable actuality of being a human being.
Of the 7 billion of us living in the world, at any one-time
pain is felt by as many as 1 in 5 people on the entire planet!
Pain is a very, very complex phenomenon which can be hard to
understand. There are a multitude of reasons why pain occurs, some of which may
even be unrelated to physical factors. So how does pain work? Why does one person
have a totally different experience of pain from the next, even if they have
exactly the same injury? Someone may suffer with chronic pain which lasts for 3
months or more whilst others could be experiencing acute pain from an injury
that has just occurred.
What is pain?
Pain is a product of danger, it is how your body alerts you
to the fact that you are harmed, hurt or injured and is the safety barometer to
avert further risk of worsening injury. When your brain interprets a situation as
dangerous, it lets you know by triggering a warning in the form of the sensory
stimulus that you feel as pain – however small the threat to your wellbeing it may
be. The pain your body feels is not always proportional to the damage being
caused, take for example a ‘paper-cut’ it’s not going to kill you but it can
really hurt! Some problems such as CRPS (Complex Regional Pain Syndrome) one of
the most sensitive pain based conditions can cause the patient to feel
excruciating pain from the lightest touch, even wind, water, cotton wool can cause
a great deal of pain to be elicited in their body. On the other end of the
spectrum life threatening diseases such as Cancer can be ‘silent’ in that there
are no painful symptoms until very late in its progression or maybe in a traumatic
injury such as a car crash, there have been reports of people with horrific
damage to their body that don’t feel pain as they are in ‘shock’ - a mental
state related to our body’s fight of flight response.
It’s not that simple
though…
However, we cannot just simply dismiss pain as purely being
an output from the brain in response to danger, there are numerous other
sources and every individual suffering with pain, especially those suffering
for months and years can involve a story, life situations, emotional stress,
trauma, all play their part.
Pain can be imprinted in our brain as a memory, let’s say
you hit our head badly on a cupboard door or slipping whilst running on a wet
swimming pool floor, or whatever it may be, certain experiences in our lifetime
that cause pain can act as a mental trigger to prevent us doing the same thing
again in the future.
Lower back pain is a very interesting example, many
differing degrees of suffering from person to person can make it somewhat of an
enigmatic condition to diagnose. Even with ‘black and white’ information from
an MRI scan, highly detailed imagery of the spine, surrounding soft tissues may
shed light on significant injury to the intervertebral discs, showing apparent
‘trapped nerves’ however in two separate scans in two different people may show
the same level of disease in the spinal discs, one person may be in agony with
horrendous sciatica but the other may have no symptoms whatsoever.
Behind the scenes and
the context of pain
When we delve a little deeper, pain levels can be broken
down further more when putting things into context, based on the perspective
situation of the person in pain. Let’s say you suffer a minor injury to your
finger, the pain experienced will mean vastly different things to a pianist
when compared to a footballer. A pianist who relies heavily on his fingers will
be more concerned by this and will be likely to pay more attention to this
injury which in turn can cause more suffering. Our brains score things in order
of severity based on the areas of our bodies we use more in day to day life and
therefore these areas will appear to be more sensitive and as a result, in an
attempt to self-preserve we will want to protect those parts as a matter of urgency.
A huge area that has another significant effect on pain is
mental emotion and mood, in simple cases having a bad can make a headache feel
a lot worse or in other cases of mental health disorders such as low mood,
anxiety, depression can all be linked to worsening painful symptoms and vice
versa.
It is also clinically proven that lack of knowledge and
understanding regarding one’s pain can actually increase the level of suffering
someone may experience, so if you have a clear picture as to why it is you are
in pain you will actually suffer less, which is why as Osteopaths we always
like to make sure our patients have a clear understanding as to why they are in
pain. Severity can also be affected by the onset and progression of the pain,
something that builds up slowly over the months will not register as acutely
painful as say a sudden break or fracture to a bone, in such incidences like a
trauma causing a broken leg.
James and Pain
Pain is an area of interest that as an Osteopath of almost
10 years now I have encountered in many different forms and severities, and
whilst Osteopathy is amazing at helping people who are in pain one area I have
become particularly interested in is the type of pain that won’t respond to
hands on therapy alone.
I am currently back at college, studying the mind-body
connection and learning to help coach people through mind based causes of
physical conditions, sensations and symptoms. The study is based on the work of
the 6 times bestselling author Sandy C Newbigging and
brings together clinically proven science fact and more holistic mind-body
approaches in the form of modern day meditation techniques and the teachings
around it, which are growing all the more popular with recent the success of ‘Mindfulness’
and its associated patient education.
I will very much be looking forward to sharing this in my
practice alongside my work as an Osteopath in the near future, so watch this
space...
·
NOI group – Explain Pain
·
Wall-Pain, the science of suffering, 1999
·
Moseley, Hodges, Nicholas. A randomised control trial
of intensive neurophysiology education in chronic low back pain.
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