Pain is described by many as a hurtful experience related to tissue damage, but stopping at that would only explain a small aspect of this complex experience. Rather, it is better to think of pain as the ultimate output. It scrutinizes multiple inputs including but not limited to hurt or damage. We now understand that emotional state, memories of past experiences, context, body location, and cultural beliefs are also relevant inputs. The combination of these is often required to create something deemed as pain and it is explained best by Melzack’s Neuromatrix Theory of Pain. His theory describes pain as being comprised of three domains. The somatosensory domain involves the sensation that our nerves pick up and send to our brain for processing.1 The cognitive domain deals with the meaning behind the pain, and relates it to past experiences as well as potential solutions.1 Lastly, the emotional domain relates to the attitude you have towards your pain.1 Keeping these things in mind, here are three facts that will completely change how you think about the experience we call pain:
1. Hurt Does Not Always Equal Damage
A recurring theme regarding the perception of pain is that hurt equates to the level of damage someone is experiencing. However, what if you have an awful onset of lower back pain but then an X-ray and MRI turns up negative? Surprisingly or not this is a common finding in literature for many injuries, just take a look at this talk by Peter O’Sullivan, professor of musculoskeletal physiotherapy at Curtin University. Pain is too complex of a phenomenon to be able to say that if “x” amount of damage occurred to your tissue, then “y” amount of pain will be experienced. Nociception, which is the perception of harm or tissue damage is only one input. It is not always sufficient for a pain experience to occur. As we just mentioned, pain scrutinizes several relevant inputs along with nociception including emotional state, past experiences, context, body location, and cultural beliefs. For example, you can have tissue damage after an injury but if you do not pay attention to it nor are you in constant fear of it, then can it really be painful? What we do know about pain is that it is a helpful message the brain receives about our bodies from a biological standpoint. Pain gives us information about the healing state after an injury and warns us to avoid certain things that can cause more harm. These adaptive features of pain are important during the acute (early) phases of an injury. When pain becomes chronic (lasting more than 3 months), it loses its adaptive qualities. Chronic pain is an impairment that can affect one’s ability to function in normal activities. Interestingly enough, it almost always has a strong psychosocial influence.
Click page 2 to read about how chronic pain and depression are biologically linked