Pain - part one

Introduction

What is pain? We all experienced one type of pain or another. From an early stages of our lives we inform our carers about pain by crying. At that point we might not be able to describe it, but our nerve system starts a series of events to let us and people around us something is wrong and requires attention. As children in most cases when we bruise our knee a mothers kiss on the injured area soothes the pain and we can carry on playing. So what’s the definition of pain? A Merriam-Webster dictionary tells us:

pain

noun

1.

a (1)

: a localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and emotional distress and typically results from bodily disorder (such as injury or disease)

acute shooting pains

also : the state marked by the presence of such sensations

was in constant pain 

a(2)

: a basic bodily sensation that is induced by a noxious stimulus, is received by naked nerve endings, is associated with actual or potential tissue damage, is characterized by physical discomfort (such as pricking, throbbing, or aching), and typically leads to evasive action

b

: mental or emotional distress or suffering : grief

the pain she had felt at those humiliating words— Morley Callaghan

2.

informal : one that irks or annoys or is otherwise troublesome

… almost everything requires a password these days, and it can be a real pain to remember them all.— Michael Cahlin

—often used in such phrases as pain in the neck or (impolite) pain in the ass/butt

His little sister is a real pain in the neck.

3.

pains plural : trouble, care, or effort taken to accomplish something

was at pains to reassure us

4.

pains plural : the throes of childbirth

5.

: punishment

the pains and penalties of crime

We can see here that when we can use the word pain in the context of physical sensations, emotional states and challenging situations. This blog will mainly focus on the physical side of pain, however we know these days that our emotions can have an effect on physical sensations and other way around – physical state can have an effect on emotions. That’s why when I see my patients for the first time, during the assessment I always ask about their current stress levels and if they experienced in the pas anything that could be classified as emotional trauma. In most cases we don’t like to experience pain. Of course, it’s unpleasant! So is pain good or bad? I try to have a neutral take on it – neither. Pain is an information. Information that something might be wrong or is about to go wrong. Frequently in minor pain it’s a warning signal we simply might be doing too much, or our body doesn’t agree with the posture we are currently in and is presented in increased muscular activity (or weakness). In many cases if the pain is minor, has been present only for a couple of days, we don’t recall any injury, doesn’t limit us from daily functioning like personal hygiene, working etc. it’s nothing wrong to just ignore it and carry on as normal. If the pain sensations we experience are lasting between one to two weeks, intensity stays the same or is getting worse it is worth to seek professional help – physiotherapist, osteopath, chiropractor, sports therapist or a massage therapist. My background is in physiotherapy, then I specialised in manual therapy – meaning using mainly my hands to help people in pain. During my education I have been trained by other physios, osteopaths and chiropractors. In fact, in Poland if you want to study osteopathic medicine or chiro you usually need to be a physio first. As I am asked frequently by my patients what is the difference between these professions I’ll quickly try to answer that here: approach and philosophy. We all want to get you better as soon as possible using natural ways of stimulating your body through manual techniques and exercises. All the other differences usually later comes to individual practitioner, their experience and postgraduate training. But I think it’s generally quite safe to say that if your body is misbehaving that it doesn’t matter which professional you will choose. Most of my patients come to see my via word of mouth. So, if some of your friends can recommend someone they trust, whether it’s physio, osteopath, massage therapist, sports therapist or chiro, try them first. Type of pain you experience is very important as well, because it can give us straight away an information about potential severity of the situation and it’s a first information if the problem requires a referral for further investigation by medical professionals – if red flags are present (we will cover that in another article). Most of my patients use words as: burning, throbbing, stabbing, ache, niggle, stitch, agony, awful, discomfort etc.. If a patient experienced an injury let’s say twisted their ankle, or experienced knee pain when playing football is usually relatively easy to point out what went wrong – potential tissue damage, strain or tear of the muscle, tendon or ligament. The challenge is when patient did not have any injury (or at least doesn’t recall having any), in fact doesn’t do many sports yet is experiencing excruciating pain for example in their shoulder. Then, for me as a therapist a conversation with a patient during initial consultation is crucial to discover what might be happening in their livers to contribute to their unpleasant experiences. If they had not have an injury other possible causes for pain might be: prolonged static position (lack of movement), repetitive movement (too much movement), hormonal imbalance, reaction to allergy or food intolerance, anxiety or depression, lack of sleep All factors listed above deserve a separate posts which I will create in near future with the explanation why it is causing aches and pains. Pain is a topic we could easily write whole books about, but I will try to keep it simple. But if you are a clinician and want to go really deep into the topic one of the books I can highly recommend is “Pain: A Textbook for Therapists” by Jenny Strong, Anita M. Unruh, Anthony Wright, G.David Baxter or a new edition of the book  “Pain: A textbook for health professionals”.

Mateusz “Matt” Ciesielski Pain Relief Therapy

hello@painreliefliverpool.com