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What is Pain

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					What is Pain?
Does pain have a purpose? Pain is normally the body’s natural way of signalling something is wrong and therefore serves a useful purpose when you are injured. Some people are born without the capacity to feel pain and this can be dangerous, these people are never able to identify when tissue damage might be occurring, because the pain is not there, so a broken bone might never be recognised and heal incorrectly causing multiple problems for the future.

PAIN
• Helps children learn about the world and what is physically safe. Helps make you take action to remove the source of a pain, like moving your hand away from a flame. Helps stop you causing further damage once injured.

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However, pain is a complex experience. Although we normally hurt when injured, a pain message sent to your brain can get changed or waylaid by all sorts of physiological and psychological processes. Pain is more than just a simple phone call sent to your brain to tell you something is wrong with your body.

Chronic Pain When you have a pain well beyond normal healing time, it is difficult to see what sort of positive value this can possibly have. Most injuries heal after about six months and pain that continues beyond such time is often called “chronic” pain. There seems to be no effective medical cure for such pain despite many attempts. This is often because the physical injury, which gave rise to the pain, has disappeared or healed.

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Why does pain continue after an injury has healed? Pain may continue because the “pain system” has changed. The brain may continue to interpret some messages as pain messages. There are a number of factors that can change this pain system: • • • The nature of the original pain. The fact that the pain has continued for a long time. Treatments that have sought to heal the pain.

A good example of this is phantom limb pain where pain is still experienced in the limb that no longer exists. Such “phantom limb pain” suggests that our brain is so powerful that it can create a feeling of the foot still being there and in pain, in spite of the sufferer knowing perfectly well that the leg has been amputated. Sometimes pain can be experienced in parts of the body where there was no injury. This is often known as “referred” pain and can be particularly common with neck and spinal pain; affecting other parts of our back, arms, hands, legs, and feet. This is because all the nerves to these parts of our body have to pass through the spine at some point and any injury or damage there can easily involve other nerves. What affects the way we experience pain? As we have said, pain is a complex phenomenon and many factors affect our experience of pain. Phantom limb pain demonstrates the powerful role of the brain in this experience. Another example is someone being seriously injured half way through an important football match but the footballer only noticing the pain when the game is over. Again this illustrates the powerful influence of the brain on pain messages. Many factors affect our experience of pain. Here are some examples:

Painwatching

Meaning of pain

PAIN
Individual Differences

Tension

Mood
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Individual differences Everyone experiences pain differently and everyone’s pain threshold is a little bit different. One person may seem to suffer badly while another with a similar injury hardly seems to notice at all. These differences are hard to explain and may be due to a number of physical, social and psychological reasons. Painwatching You may notice that when you sit and think about your pain and attend to it very carefully, it seems to hurt more. Similarly, if you switch your mind away from the pain, you notice it less. This could be one of the reasons why many pains seem worse in the evening or at night when there is less distraction available. When you are busy working or having a good laugh with friends, your pain may be less noticeable. We are not suggesting that the pain goes away when you are absorbed in something interesting, but that you may notice it less. Tension Many people have commented that their pain gets worse when they get tense and upset. Of course pain itself makes us tense and upset – so this can be a bit of a vicious circle. Mood It has been noticed that some people with long-term pain can get very depressed. This is hardly surprising if people are feeling helpless and trapped by their pain. But we also know that depression can make pain more noticeable and harder to cope with, so again, there is a possible vicious circle. The meaning of pain The meaning of pain can also affect how much pain we feel. For example, it was noted that soldiers in the Boer War asked for painkillers far less often than civilians who had similar injuries. It therefore seemed that the meaning of the injury was significant.

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All these examples demonstrate the importance of our thoughts and feelings on the experience of pain. They certainly show that the mind has a big effect on how much our pain hurts. They demonstrate how our brain can over-ride, exaggerate, or even delay noticing pain messages.

Health Psychology Service Chesterfield PCT Feb 2004

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