What is pain?


All of us have different perceptions and interpretations of pain, and we may ask ourselves at some point what it is and what is it trying to tell us.

In some circumstances, pain could indicate tissue damage. Many people believe it is weakness leaving the body, or a badge of honour from a hard day’s work.

Our current understanding of pain has changed substantially over the past decade with pain being viewed more as a ‘protector’ or ‘perceived danger system’ versus the traditional ‘indicator’ of tissue damage.

The most recent definition of pain from the International Association for the Study of Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

Health Clinic, Physiotherapy

Pain is necessary for life and is good a thing.

It gets our attention if our hand is too close to the fire, if we step on something sharp in woods, or if we’re working too hard for too long.

Pain is the brain’s final output after processing and evaluating ‘danger messages’ (i.e. nociception) coming from ‘danger detectors’ (i.e. nociceptors) in body tissues.

The brain evaluates all of the messages coming in and decides if there is a perceived need to protect and if the threat is great enough. If the body feels threatened, the nervous system will get our attention by evoking the sensation of pain.

Similar to a smoke alarm, pain will get our attention and make us take action to change it.

At times, if pain persists beyond 6 to 8 weeks, our ‘danger detection’ system could get more sensitive and start detecting more signals than usual, resulting in pain after smaller bits of physical activity. This is almost no different than if we feel tired, hungry or thirsty; we get ‘body talk’ that gets us to take action, and if we don’t, the sensations may intensify.

Acute pain may occur from a quick twist of the ankle or knee, where we get pain from tissue damage secondary to a trauma or definitive mechanism of injury. In other scenarios where there is no true mechanism of injury, like acute low back pain when just bending to tie your shoe, we want to investigate the circumstances leading up to this event.

Many things can make us more sensitive to pain such as psychosocial factors (i.e. depression or anxiety), past adverse experiences, prolonged stress, inadequate sleep, physical activity habits or diet choices to name a few. In these cases, it could be a combination of things creating a sense of ‘danger’ or ‘threat’ within the system leading to some body region becoming symptomatic - this again is the brain trying to get our attention again and get us to take action.

If you’re in pain, try to create more ‘safety’ within the body.

This could be accomplished by finding a balance between being physically active and taking rest, sleeping and eating well, reducing stress, and incorporating meditation, progressive muscle relaxation or breathing techniques into your day. If you need a plan of action, consult with your health care provider to find strategies and discover effective solutions for your symptoms.

Sean Overin, Physiotherapist

By Sean Overin, Physiotherapist