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Phenomenon of pain

Pain is a universal experience that can impact our lives in many ways. From a physiotherapist's perspective, pain is defined as an unpleasant sensory and emotional experience that is associated with actual or potential tissue damage. However, pain is not just a physical sensation, but can also be influenced by emotional and psychological factors such as anxiety, depression, and stress.

Pain is often the tipping point in why people come to see me for help and sometimes the expectation is that it then vanishes after one session. Pain is weird and can be disruptive in our lives changing our behaviors, choices, mood and our overall lifestyle and can cascade into more sinister thoughts if persisting for a long time.

However pain can actually be helpful in some cases as it can signal that something is not right in the body and prompt us to take action. For example, pain from touching a hot stove can prevent us from sustaining a more severe burn. Pain can also serve as a protective mechanism, causing us to avoid movements or activities that may cause further harm or injury.

Physiologically, pain is the result of the activation of nociceptors (pain receptors) in the body. These nociceptors send signals to the brain, which interprets them as pain. It can be expressed in various ways, such as sharp, dull, achy, or radiating.However, pain is not always a reliable indicator of tissue damage because it can be influenced by emotional and psychological factors. For example, a person with chronic pain may experience pain even when there is no actual tissue damage. It is important to note that the pain experienced by a person with chronic pain is very real, even if there is no actual tissue damage.

In 2018, I experienced discomfort in my stomach which could be described as a rumble or churning, but nothing worrisome. Being an American, going to the doctor usually means big $$$, but living in Australia and having Medicare (woot woot), my wife convinced me to get it checked out. After waiting nearly a week, I reluctantly went to see a doctor during my lunch break to make her happy. The doctor conducted an ultrasound and asked me about my pain levels. I responded, "maybe a 2/10." As he discussed the unusual findings and the contrast of evidence versus my experience of pain with his intern, he finally asked me to immediately go to the ER because my appendix was about to burst.

Only after finding out that information did my body start to experience excruciating pain and chills throughout. Prior to this information, my brain and belief systems led me to believe it was a normal day in life. I was quite a healthy person, reasonably fit and young, so there wouldn't be any reason for me to feel unhealthy or sick.

Pain is a weird and complex phenomenon. Based on my experience, a part of me wished I had endured more pain earlier, as it would have alerted me to address the issue sooner and trust my "alert system." It's like sleeping in a burning house when the fire alarm doesn’t go off- no one would want that.

My first priority as a physio is to get you out of this stage. We embark on a journey of discovery, during which I ask you millions of questions while experimenting and exploring your movements and patterns in order to figure out what's causing all this discomfort. As we work together through this experience, we can create a profile not only of your physical symptoms, but also of your thoughts, worries, and fears about what's happening. We can then agree on the variables that make it feel better or worse. Armed with this insight, you can have the power and knowledge of take back control on whats happening within your body.

I may perform some hands-on work or suggest movement-based activities to help alleviate your pain. Having clarity on a management plan can help you anticipate stages of pain and stay on top of it just in case it gets re-aggravated. And remember, it's not the end of the world if it does. Though it may sometimes feel like it, as the wise saying goes, "this too shall pass."

Joel NucumComment