Friday, 22 July 2016

An introduction to Pain, explained…


In this article osteopath and clinic director James Clapham shares his insight and expertise on pain in this snapshot introduction to explain pain.

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...

References
 
·          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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