What is pain?

Often the cause of pain is obvious, a broken leg, or a bruise. But there are times when the source of pain is unseen, for example a slipped disc. Occasionally it is very difficult to find the exact cause of a person’s pain. Health professionals like Physiotherapists and doctors use different terms to describe different types of pain such as:

Acute Pain: This is short-term pain, like when you sprain your ankle.

Chronic or Persistent Pain: This is long-term pain, such as the discomfort from arthritis or back problems.

Recurrent or Intermittent Pain: This is pain that comes and goes, like a toothache.

Acute pain acts like an alarm, signalling that something is wrong. Many types of acute pain are easy to treat, but some may indicate a more serious problem. For example, the pain from a broken leg helps you rest the leg until it heals, which is beneficial.

Chronic pain, on the other hand, often doesn’t serve a useful purpose. It’s like a warning system that stays on even when it’s no longer needed, such as with arthritis or long-term back pain. This type of pain can affect what you can do, your ability to work, your sleep, and even your relationships with family and friends.

Pain signals travel through your spinal cord and specialized nerve fibers to your brain. This system involves your entire body and works like a powerful computer that processes these signals. However, sometimes this system can malfunction, causing the brain to misinterpret the signals, leading to chronic pain. Unfortunately, we can’t simply “reset” this system.

Your emotions play a big role in how you experience pain. If you’re feeling angry, depressed, or anxious, your pain may feel worse. Conversely, when you’re feeling positive or happy, your pain can seem less intense, making it easier to cope.

This shows that pain is not just a physical experience or just in the mind; it’s a complex mix involving your whole being. Your experience of pain can change from day to day.

Sometimes, pain can start small but quickly spread through your body, similar to how one person starting a chant at a football game can quickly get the whole crowd involved. This is known as “wind-up,” and it’s one reason why chronic pain is difficult to eliminate. The “chant” of pain can continue for hours, days, or even years, leading to a long-term problem that requires time, patience, and skill to improve.

Pain signals are transmitted by chemicals called neurotransmitters. Some neurotransmitters make pain worse (bad neurotransmitters), while others help block pain (good neurotransmitters). Your emotions can influence these neurotransmitters as well. Doing things you enjoy, laughing, or exercising can boost the good neurotransmitters and reduce your pain. On the other hand, feeling depressed, unmotivated, or inactive can strengthen the bad neurotransmitters, making your pain worse.

Several things including pain medication, physical exercise, a healthy lifestyle and good sleep can also help strengthen the good neurotransmitters, reducing pain.

Medical advancements have helped us understand and treat pain better, but there’s still much to learn. Today, physios and doctors understand that your personal circumstances greatly affect how you experience pain. You need to be able to explain your pain clearly, and healthcare professionals must try to understand and help in the way that’s best for you. using a numerical pain rating scale can help with this. We have used the numeric pain rating scale in our rehabilitation plans and some of the advice we give. Below is a section which should help you understand how to use the pain scale most effectively.