• Jan Baker

What are the different types of phyiscal pain?

Updated: Nov 22, 2021

Pain can be an invaluable alarm bell to tell us something is wrong. Acute and chronic pain are highly motivating - they both wake you up & call you to take action. So what is pain?

The first thing to understand that pain is a subjective sensation. What is agony for one person, can be mildly uncomfortable for someone else. The International Association for the Study of Pain defines pain as an "unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage". I prefer to think of it as a warning sensation to your brain that some type of stimulus (a cut, burn etc.) is causing or may cause damage, and that you should probably do something about it.

So how does it work? Well, the stimulus (cut, burn etc.) triggers a sensation in the nerve. The nerve sends a signal to your brain via your central nervous system, up through your spine. The brain then processes the information. The first thing you may feel is an intense pain at the site of injury. This can then be followed by a prolonged, slower, dull ache.

It's not known quite what happens when the signals reach the brain. Some signals are obviously sent back immediately; your instinct is to pull away from what's causing the pain. But interestingly, the brain can also change how you feel:

  • The pain eventually subsides or reduces to a lower intensity.

  • If you consciously distract yourself, you don't think about the pain and it bothers you less.

  • People given placebos for pain control often report that the pain ceases or diminishes - so you can basically convince your brain there's nothing wrong without any actual treatment.

It's important to remember though that the brain just receives the signals, in itself, it is just a tool for processing pain. It doesn't actually have any pain receptors.

Your body also changes in response to pain. Your heart rate and blood pressure increases, sweating can occur and breath can become rapid and shallow. The extent to which these occur is of course, dependent upon the intensity of pain, but as I've said, they can also be depressed by the brain filtering information back to the site of injury. This increase in heart rate etc. is your "fight or flight" response kicking in.

Your age can also have an affect on how much pain you experience. Brain circuitry generally degenerates with age, so older people have lower pain thresholds and have more problems dealing with pain. Research shows that women have a higher sensitivity to pain than men do. This could be because of sex-linked genetic traits, and hormonal changes that might alter the pain perception system. Men are often also not expected to show or report their pain to the same degree as women.We often experience more pain when our body is stressed from lack of sleep - this is why pain often becomes such an issue with chronic fatigue syndromes, such as fibromyalgia & ME. Finally, how we have experienced pain in the past can influence neural responses. How many people remember what a stubbed toe feels like? And would you avoid it again if you could?

So what's the difference? Acute pain is caused by an injury to the body. It warns of potential damage that requires action by the brain, and it can develop slowly or quickly. It can last for a few minutes to six months and goes away when the injury heals.

Chronic pain persists long after the trauma has healed (and in some cases, it occurs in the absence of any trauma). Chronic pain does not warn the body to respond, and it usually lasts longer than six months.

It is also thought that we have "pain gates" throughout our nervous system. When we are in pain, these gate are firmly open. When we don't have acute pain, the gates remain shut. This theory doesn't tell us everything about pain perception, but it does explain some things. If you rub or shake your hand after you bang your finger, you stimulate the area. This potentially closes the gate and reduces the perception of pain.

And so finally, how do you treat it? NSaid medication such as ibuprofen and naproxen can have some adverse effects in the liver and kidneys and can cause gastrointestinal discomfort and bleeding with prolonged use. Opioids such as codeine or zapain can be easily overdosed and become addictive. So these are not ideal, especially long term. For better drug- and chemical-free help I'd look at the following:

  • Chiropracty manipulates joints to relieve compression of nerve but this is not helpful if it's a muscle tear or you have any stress-related issue.

  • Massage stimulates blood flow, relieves muscle spasms and if combined with essential oils, can relieve both chronic and acute pain quite effectively in a relatively short space of time.

  • Hot applications increase blood flow, and cold applications reduce inflammation, which contributes to pain - use with essential oils for best effect. Your therapist can tell you how to use these two methods together for best effect.

  • Acupuncture may stimulate nerve cells and release endorphins. The increased stimulation might also close the gates to pain.

We all experience pain at some point. Understanding that it is there primarily to protect us from threats helps us deal with the discomfort it gives us. Acute pain protects us from imminent danger and chronic pain also tries to protect us by discouraging us from overusing muscles that may need to recuperate and heal for longer. But not all pain is harmful or permanent. Remember, just because your muscles are sore after a work out at the gym or from playing sport, that doesn't necessarily stop you from doing it again....

I've leave you now with a couple of questions: How far is the pain you feel productive or debilitating? How do you know? And if we know that massage helps both productive and debilitating pain, when was the last time you got one?

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