What is pain?

Aug 09, 2021 4:58pm

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. 

If you would prefer to watch us discuss pain, you can check out this video series!

 

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.”

However, 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.”

Let’s look at the first part of that definition, pain is an unpleasant sensory and emotional experience. 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 phenomenon where a person can feel pain in a limb that was amputated decades ago. That is, they feel pain in a body part that doesn't exist. The logical conclusion that comes from this phenomenon is that the pain exists in the brain, not in the body part that hurts. The pain is a sensory experience, in that it is “felt”. But it’s also an emotional experience, and is related to our past experiences, expectations and beliefs. 

 

What does pain mean?

Let’s look at the second part of our pain definition, pain is associated with actual or potential tissue damage. Pain is our body's way of warning us about 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.

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 (my brain experiences 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. A pain response can be initiated by something that is not actually dangerous and not causing harm. In our house alarm analogy, this would be like a bird flying into the window that sets off the alarm, rather than a burglar breaking in.

 

Does hurt = harm?

Pain does not always mean something is wrong. This can be a little hard to believe at first, but the best pain science we have supports this concept. 

This doesn’t mean pain is never the sign of something actually being wrong. If you trip over and break your 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?

When it comes to pain, complete rest is not the solution. In fact, oftentimes complete rest will make the problem worse. 

Relative rest is sometimes necessary, however this usually applies to an acute, specific injury. This doesn't mean doing nothing - but if you have a recently broken arm that is still very sore, trying to do lots of push ups is probably not a good idea. In this situation, doing some cardiovascular exercise such as going for a walk or riding a stationary bike would be good alternatives to complete rest. Exercise has many benefits to your overall health, and can have an analgesic effect (reduce pain) too.

If you have pain that has been around for a long time, rest is not going to help you. You must begin exercising and moving 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.

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 it becomes tolerable)
  • Reduce the range of motion (eg. squat a little bit less deep; until it becomes tolerable)
  • Change the movement slightly (eg. do a sit-to-stand form a chair, instead of a full squat; until it becomes tolerable)

 

What is the best thing to do for pain?

  1. Exercise (get the sore thing moving)

    AND

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

The great news is, by reading this you have already taken a big step towards accomplishing that second point.

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

And once again, here is our video series where we discuss some of the topics in this article!