15 May What Is Pain & When You Should Seek Help?
The most widely accepted definition of pain, established by the International Association for the Study of Pain (IASP), is “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
Pain is the result of our body signalling to our command centre, our brain, that there is a threat to our integrity. Pain typically signals change or injury to the body. With this immediate feedback, the body initiates a line of defence to protect itself from further harm or damage. Pain is therefore an important part of our defence mechanism. It is a monitoring system. While the experience is unwanted and unpleasant, without pain we can unintentionally harm ourselves further.
For hundreds of years, it was thought that pain was a direct response to damage. By that logic, the more severe an injury is, the more pain it should cause. But as the science of pain evolved, it was discovered that pain and tissue damage don’t always go hand in hand, even when the body’s threat signalling mechanisms are fully functioning. We are capable of experiencing severe pain out of proportion to an actual injury, and even pain without any injury. How is that possible?
There are two phenomena at play: the experience of pain, and a biological process called nociception.
Nociception is part of the nervous system’s protective response to harmful or potentially harmful stimuli. Sensors in specialized nerve endings detect mechanical, thermal, and chemical threats. If enough sensors are activated, electrical signals shoot up the nerve to the spine and on to the brain. The brain weighs the importance of these signals and produces pain if it decides the body needs protection.
Typically, pain helps the body avoid further injury or damage but there are numerous factors besides nociception that can influence the experience of pain— and make it less useful.
First, there are biological factors that amplify nociceptive signals to the brain. If nerve fibres are activated repeatedly, the brain may decide they need to be more sensitive to adequately protect the body from threats. More stress sensors can be added to nerve fibres until they become so sensitive that even light touches to the skin spark intense electrical signals.
In other cases, nerves adapt to send signals more efficiently, amplifying the message. These forms of amplification are most common in people experiencing chronic pain, which is defined as pain lasting more than 3 months.
When the nervous system is nudged into an ongoing state of high alert, pain can outlast physical injury. This creates a vicious cycle in which the longer pain persists, the more difficult it becomes to reverse.
Psychological factors clearly play a role in pain too, potentially by influencing nociception and by influencing the brain directly.
A person’s emotional state, memories, beliefs about pain and expectations about treatment can all influence how much pain they experience.
In one study, children who reported believing they had no control over pain actually experienced more intense pain than those who believed they had some control.
Finally, social factors such as the availability of family support can affect one’s perception of pain.
As such, a multi-pronged approach to pain treatment that includes pain specialists, physical therapists, clinical psychologists, and other healthcare professionals is often most effective.
WHEN TO SEEK HELP
You should seek immediate medical attention for your pain if it is:
- the result of an injury or accident that may have caused significant damage to your body, including severe or uncontrollable bleeding, broken bones, or an injury to the head.
- an acute and sharp internal pain, which may be an indication of a serious problem such as a ruptured appendix or bowel perforation.
- located in your chest, back, shoulders, neck, or jaw and accompanied by other potential signs or symptoms of a heart attack, such as pressure in your chest, shortness of breath, dizziness, weakness, nausea, etc.
- interfering with your daily routine, hindering your ability to sleep, work, or participate in activities that are of importance to you.