What is Pain?

The widely held belief throughout the history of medicine has been that we have pain receptors throughout the body and when there is damage to a tissue they are triggered. The signal then travels to our brain and is controlled by a specific part of our brain that controls pain.

This theory does make sense; however, it does not explain Phantom limb pain in the absence of an arm or leg after amputation. It also does not explain how people can be shot during wars and not feel the bullet wound.

The last 10 years have seen extensive research into the causes of pain, led by Lorimer Moseley and David Butler. Their research has shown that the previous held beliefs are incorrect, and that pain is very complex indeed. Their research has shown that pain is essentially our brains interpretation of a message. We have nociceptors in every tissue of our body. These nociceptors are danger receptors. They are triggered when our tissues perceive danger. The signal then travels to our brain via a complex pathway and then our brain interprets the message. Real time MRI imaging has shown that the same painful stimulus will trigger different areas of our brain to “light up”. The same person may even have differing results over different tests depending on many factors.

That begs the question, why? As stated before, pain is our brains interpretation of a message. Therefore, any process within our brain, which can be an infinite number of things, can contribute to our pain response.

Research has shown that the following things will increase our pain response: –

Memories of previous injury

Stress

Anxiety

Depression

Fatigue (tiredness)

Negative beliefs about pain/injury

Panic/ fear

Research has shown that the following things will decrease our pain response: –

Being rested/ not tired

Stress

Positive outlook

Belief that you will improve.

Knowledge of pain neuroscience

The take home message from all this is that severe pain does not always equal severe pathology (damage).

Your physiotherapist is uniquely qualified to properly assess, treat and educate you about your painful condition. If needed, we will refer you to another health professional for further investigation/therapy.

By Peakhurst Physio

Caring for the whole person, not just the injury

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