Pain

Uncategorized Aug 08, 2020

 

🎵  Pain! What is it good for, absolutely nothing! 🎵

Well actually, that’s not true. Pain is a very important evolutionary mechanism. It has evolved over millions of years to protect us, and keep us safe from harm. However, like many other evolutionary mechanisms (such as the drive to eat fatty and sugary foods!) it doesn't always serve our best interests. 

 


What is pain?

If you google search a definition of pain, you might find something like this: 

“Pain is a highly unpleasant physical sensation caused by illness or injury.”

But that’s not actually very accurate. Recent developments in pain science have changed the way we think and talk about pain, in important ways. A definition of pain that more appropriately fits our current understanding, would be something like this:

“Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.”

If those two definitions don’t look meaningfully different to you, then I urge you to read them again. 

It is important to understand that pain is not just a physical sensation. A great example of this is “phantom limb pain”. This is a nasty phenomenon where a person can feel pain in a limb that was amputated decades ago. That’s right, they feel pain in a body part that doesn't exist! Something else must be going on here. The only logical conclusion is that the pain exists in the brain, not in the body part that “hurts”. 

So if pain is in the brain, and pain is a sensory and emotional experience (rather than a physical sensation) then the logical next question is why exactly do things hurt?

If I trip over and break my arm right now, why does it hurt? 

If I hold my hand on the hot kitchen stove for 10 seconds, why does it hurt?

 


What does pain mean?

Pain is our body's way of warning us about harm (actually harm or potential harm). It does this to elicit a response, or a change in behaviour. If the hot stove hurts your hand, you will pull your hand away. Very quickly. 

In this way, we can think of pain like a house alarm. When a burglar breaks in a window (my hand touches a hot stove), the house alarm sounds (the brain creates pain), and I wake up and call the police (I pull my hand away from the stove). 

However, there is one very important thing to note here. The alarm system (pain) can be triggered by something that is not actually dangerous. Read that sentence again. We can have pain when there is no actual danger or damage. In our house alarm analogy, this would be like a bird flying into the window that sets off the alarm, rather than a burglar smashing it in.

So pain is an imperfect mechanism.

 

Does hurt = harm?

If my house alarm analogy made sense, then you may be realising that pain does not always mean something is wrong. This can be a little hard to believe at first. But trust me. The best pain science we have backs up this idea.

So if I am doing some squats, or walking up stairs, and my knee hurts. Does it mean I am doing damage? NO!

Now, this doesn’t mean pain is never the sign of something actually being wrong. Like I said earlier, if I trip over and break my arm, it will hurt for a valid reason. 

But for most of the pain we feel; most of the general aches and pains we experience; most of the “wear and tear” and “arthritis” and “dodgy knees” that we complain about, there is no actual harm. Hurt does not always equal harm.

 

Should I rest if something hurts? Should I stop exercising?

These are probably the most important questions. And the easiest to answer, albeit with a few caveats.

Complete rest is never the right answer. In almost every case, it will actually make the problem worse. 

That being said, relative rest is sometimes necessary. This usually applies to an acute, specific injury. This doesn't mean doing nothing. But if you fall and break your arm, then trying to do 50 push ups the next day is probably not going to be a good idea (or even possible). But perhaps, you can go for a long walk, or do some balance exercises, so you’re less likely to trip over again!

If you have pain that has been around for a long time, then rest is not going to help you. You must continue to exercise, and move the sore body part. This may be a little tough at first, but it will almost always result in the fastest resolution. Movement is medicine people!

If something is feeling very sore, the exercises may need to be modified slightly, to make it more tolerable. Here are some general tips that you can follow, if a particular exercise is tough for you at the moment.

  • Reduce the load (eg. hold a bit less weight; until you get stronger)
  • Reduce the range of motion (eg. squat a little bit less deep; until you get stronger)
  • Change the movement slightly (eg. do a sit-to-stand form a chair, instead of a full squat; until you get stronger)

 


What is the best thing to do for pain?

There are two solutions here. Two things that, all the best research shows, are the unequivocal kings of pain management.

  1. Exercise (don’t be afraid to get that sore thing moving)

    AND

  2. Education (learn more about pain, how it works, and what it means)

The great news is, if you have stuck with me this far, you have already made a huge step towards accomplishing that second solution.

If you want to learn more about pain, check out this awesome resource:
https://www.tamethebeast.org/#tame-the-beast 

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