Everyone has experienced pain at some point in their life, but what is it? This is a huge topic in the research world and is one of the main reasons people come into physical therapy. This week I wanted to do a brief post explaining a very small amount of what pain is and why we experience it. Also, I provided some links (at the bottom of this post) to two informative and entertaining videos by some of the current leaders regarding pain science. The first link is a Ted Talk video that does a really great job at explaining the psychological side of pain and why we feel it. The second video describes a few treatments for people who are experiencing chronic pain on a daily basis.
First off, there are two different time frames when it comes to people in pain. One is acute pain, and this occurs instantly or soon after an accident, such as a sprained ankle, burning yourself on a stove, or basically any injury. It makes sense why we would experience pain here because it is your body letting you know that it is hurt or in danger of being hurt. The other type of pain is chronic pain. This is a multidimensional phenomenon, which can be a result of many different stimuli. Some of the most interesting causes of chronic pain to me are the psychological, or emotional factors. Aside from the rest of this post, the first video link provided does a really great job at explaining some of these.
This past week I had a similar experience to the one they talked about in the first video with having a heightened nervous system, or as many people call it “being on edge”. While I was surfing this past week, I was the only one out and the water was a little murky because of some currents and sand. I have no idea why, but a random thought of sharks popped into my head. This put me a little on edge especially since I was out by myself. Next thing I knew, a very tiny piece of seaweed touched my foot and I jumped like a little kid would (one good thing about being the only one out there is no one saw this happen). But this is a perfect example about what our nervous system does when there is even a potential threat.
So how does this relate to chronic pain?? Well this is the best part. For everyone who has had an MRI of a body part because they’ve had pain come and go for over 3 months or even years, was your pain/symptoms worse after getting the results?? Here is a good analogy for why this usually happens. If you were sitting at home and heard a noise outside, you might not think very much of it. However, if someone told you there were burglars in the neighborhood, then you heard a noise outside, you might be more inclined to check it out at the very least. This is because your senses would undoubtedly be heightened after hearing a noise outside with the information of the potential burglars in the neighborhood.
I have heard plenty of stories from patients on internship and from other physical therapists saying they got an MRI result, which showed they have a herniated or bulging disc. It puts the thought in their head that they are damaged or fragile, so they become scared to move. That if they move their back wrong their disc will fully slip out (this can’t happen) and they will further damage their back. By educating patients on what is happening to de-catastrophize a problem, empowering them to take control of their pain, and teaching them exercises to safely move their back (or whatever body part may be affected by the chronic pain), there is a much higher chance of them returning to a happier, healthier life.
If you are someone experiencing chronic pain, I would recommend finding a good physical therapist who understands current research in pain science, which is a very important step on the journey to living a pain free life. Secondly, if you are interested in this topic, I would recommend reading the book, Explain Pain, by David S. Butler and G. Lorimer Moseley (who is the speaker in the Ted Talk video). I hope everyone found this post helpful, entertaining, and educational!
William Schopp, SPT
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