Over the last 5-10 years we have learned A LOT about pain and how it works, but a lot of this is completely foreign to most people, so we’ve decided to produce a series of articles to help people actually understand their pain and what is going on… Firstly because KNOWLEDGE IS POWER! And secondly because understanding why you feel how you feel is empowering and de-threatening (as they say – just knowing is half the battle)
This is part two of a 5-part series on learning how pain works!
PAIN IS A WARNING SYSTEM
The experience of pain is part of your body’s and brain’s warning and protective system. We’re incredibly smart when it comes to trying to stop our selves getting damaged or dying, so we have a whole host of systems built in to try and avoid us coming to grief.
Now often we think that pain = damage, but we now know that pain often occurs long before any damage actually occurs.
Did you ever get a “Chinese burn” from another kid at school? Hurt didn’t it? But any damage to your arm? Not at all.
Or a better example – have you ever touched something hot, and it HURT! So you automatically pulled away (something called a withdrawal reflex – another clever way we are designed to stop hurting ourselves).
You check your hand… but it looks ok. It hurt for a few seconds, and that settles down within 10-30 seconds. Lucky you!
This is a great example of pain without pathology, or damage. The pain you experienced (immediately and possibly severely) was a STRONG warning that you are at high risk of damage if you don’t change your behaviour (touching the hot thing). Because of the experience of pain you have managed to completely avoid any tissue damage at all (clever you). Your pain served as a perfect warning system.
Even when you have an issue, your experience of pain can still be part of your body’s protective systems. Your brain (and your body) will actually try to actively give you more pain to stop you doing things it may think are potentially more damaging.
As an evolutionary example: Say you’ve sprained your ankle, so you’re not able to run as fast as normal. This means that if you and your Neolithic buddies are out hunting woolly mammoths you could be more likely to get injured and killed (not to mention potentially do more damage to your ankle). By creating pain, which makes you unable to participate, your brain is actively trying to stop you getting killed.
This may be a bit of an extreme example, but it’s true. When you have an injury, there are chemicals released by the body (in the inflammatory fluid) that actually make your receptors more sensitive (so they will send signals to your brain that things that wouldn’t normally tell you there is pain NOW tell you there is pain.) Part of the injury process actually tries to make it MORE painful for you.
Luckily nowadays we don’t have to fight for our lives, so a lot of this is fairly redundant. But that doesn’t stop it from happening. So, more pain doesn’t necessarily equal more damage. If anything, it just indicates more warning from your brain and body.
So when it comes to our aches, pains and injuries… It’s good to know that pain is your body’s rudimentary warning system that something bad MIGHT happen, not that there is already damage. Knowing this helps us know that if sometimes our pain is worse, it doesn’t mean you are MORE damaged. It might just be your brain paying more attention for some reason.
Stay tuned for Part 3 of our ” How pain works” series – and learn how your brain can choose to ignore sensory inputs (like pain) so you don’t feel them
Julian is the Director and Principal Physiotherapist at EMC Physiotherapy. He has spent over a decade working exclusively in private physiotherapy practice, and estimates he would have performed over 40,000 individual treatments in that time. He has worked with everyone from Paralympians, elite athletes, WAFL Footballers, the Defence Forces and weekend warriors; to thousands of everyday people with all manner of issues. He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries.