What is pain? The Physioactive explanation
At Physioactive, we are continually surprised by the poor understanding of pain by many of our clients and their healthcare providers. Knowledge can be very powerful and understanding why you have pain and what type of pain you are suffering from is paramount in the success of its treatment, and ultimately its elimination. Here is a brief description of why pain is an important sensory mechanism used by our bodies to protect it from injury and why understanding each of the 3 types is necessary. Our thoughts, beliefs and fears can influence our pain. “Fear leads to anger, anger leads to hate, hate.. to suffering” (Yoda).
Nociception – Pain #1
Nociception is a signal that is sent from specific receptors in our body (the skin, muscles, bone, organs etc). You only feel pain when these receptors are sending signals to the brain. As soon as this signalling to the brain stops, the pain disappears. This is the response we would expect when we are about to step on a nail or if we were to touch a hot stove. In these situations, the nociceptors send a pain signal to our brains so that we don’t step further down on the nail or remove our hands quickly from the hot stove. When these nociceptors turn off and stop sending signals, the pain goes away. In both of the above situations, the main purpose is to protect the body from injury.
There is a very serious disease where people do not feel pain and thus are continually burning and injuring themselves because this very important pain system is broken. See, pain has a purpose and can be important.
Inflammatory Pain (Inflammation) – Pain #2
Inflammation causes pain with a corresponding release of chemicals once tissue damage has occurred. Inflammatory pain remains after the injury has occurred. If we don’t pull our hand away from the hot stove fast enough or if we step through the nail instead of removing our foot, the nociceptive pain becomes inflammatory pain due to the tissue injury that has occurred. The chemicals released by our bodies stimulate pain receptors to prevent further injury and to start the healing process. Inflammation is essential for tissue repair to occur. Acute inflammation typically lasts between 24 to 48 hours after injury after which tissue regeneration begins. When you suffer from inflammatory pain, your pain should gradually reduce as the healing process and tissue repair occurs. This pain typically resolves with the normal passage of time and regular physiotherapy.
Neuropathic Pain – Pain #3
This last type of pain, neuropatic pain, is the most common cause of chronic pain. It occurs long after nociception (the injury) and inflammation (the healing process after the injury) have passed. At this point most medical tests such as MRI’s are no longer useful in the diagnosis of neuropathic pain.
When you suffer from neuropathic pain, many generic diagnoses often accompany this pain. Examples include: fibromyalgia, depression, chronic fatigue and widespread arthritis with constantly changing pain from left to right, from legs to arms, and from stomach to back. When suffering from this pain, patients almost feel helpless as traditional medical tests can not be used to diagnose neuropathic pain. Your therapist at Physioactive will use a “neuropathic assessment” to assess joint range of motion, sensory changes, look for nerve function alterations which may include hair loss, trophedema (some people call cellulite), goosebumps (pilo-erection) and sudomotor changes such as sweating and coldness.
Neuropathic pain: Does this describe the pain you are feeling?
- Pain in the absence of ongoing tissue damaging processes
- Pain felt in a region of sensory deficit
- Mild stimulus such as light touch causes extreme pain (allodynia)
- Pronounced summation and after-reaction with repetitive stimuli
- Loss of joint range of motion or pain caused by the mechanical effects of muscle shortening