The Truth About Pain

Posted on March 15 2018

Did you know that pain is a vastly misunderstood concept? In fact, most of our patients (and many healthcare professionals, for that matter) oversimplify the concept of pain: “take a few pills and problem solved” … “snip this, cut that, and you’ll be as good as new.” However, anyone with chronic pain, fibromyalgia, or phantom pain can attest to the debilitating effect of the day-in and day-out battle with discomfort.

Let’s start with the traditional view of pain, developed in 1644 by Rene Descartes.

In Descartes’ time, pain was believed to be the result of some enigmatic phenomenon, like evil spirits or one’s sins. However, Descartes hypothesized that pain was a signal passed along nerve fibers to the brain. Picture someone reaching into an open flame ... this would immediately send a message of "PAIN!" to the brain. This was pretty crazy stuff, by 1644 standards.

Descartes started the process of taking mysticism out of the pain equation. We now know, however, that pain is actually the result of three key variables working in tandem:

    • Cognitive-related stimuli—memories of past experience, attention, meaning, and anxiety.
    • Sensory-signaling systems—physical sensations resulting from the epidermis (skin), internal organs and musculoskeletal inputs.
    • Emotion-related brain areas—primarily dealing with survival instincts (fight/flight).

      Getting back to our fire example, there is more going on in our fire-pain scenerio. In addition to nerve fibers telling the brain that something hot is touching the hand, we now know that the brain is an active participant in the process and is able to make some calculations and assess the situation based on thoughts, emotions, and memories. Simply stated, pain relies on the context of the injury. That’s why a child often looks to his parents before crying after an injury occurs… the child wants to put the experience into context.

      hurt child

      When injury occurs, all of the input and context helps the brain determine if there is a threat to the body. If the brain’s opinion is ‘yes, there is threat,’ then the brain produces pain to make us pay attention. However, this is just the brain’s opinion. Sometimes the brain is wrong.

      The big idea here is that HURT DOES NOT PURELY EQUAL HARM, or the amount of pain you experience isn’t necessarily related to the amount of change or damage occurring in your body. We have many examples of this now. Studies show that things like: bulging discs, degenerative joint disease, and even bone-on-bone knee arthritis actually occur quite frequently in people who don’t have any pain or limitations.

      Don’t get me wrong. YOUR PAIN IS REAL, it just may not be telling you what you think it is telling you. Your pain is actually necessary and protects you from doing things like burning your hand when grabbing a hot pan (or lifting a heavy box without using proper lifting technique).

      Bottom line? If you have pain, it’s a good idea to be seen by a physical therapist who can often provide the best course of action for your specific issue. A physical therapist will educate you on the mechanisms of your pain and determine treatments for your healing. Research even shows that just knowing how pain works has actually reduced the amount of pain that some people feel.

      Check out a great infographic about back pain from our friends at the American Physical Therapy Association (APTA) to learn even more!  (Click image below to see the full infographic.)

      back pain infographic APTA


      At Fit Physical Therapy, returning you to an active lifestyle is our ultimate goal. We’ve helped thousands of others get back in the game of life, and we look forward to helping you. Here’s what patients have to say.

      To schedule an appointment, call Fit Physical Therapy at 303.409.2133 or contact us via our online web form.




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