Pain and Damage – The Paradox of Pain
Pain is a very significant personal and public health issue in the world, with estimates that around thirty percent of adults suffer some kind of pain problem.
Pain is a very complex mix of bodily sensations and psychological influences and is an an entirely subjective matter in that no-one else can feel your pain and the only way we can understand someone’s pain is to listen to how they describe it.
The complexity of pain has meant that investigations into what it means, how pain is generated and what pain means has been going on for centuries, although it is only recently that huge advances in understanding pain mechanisms have occurred.
Injury, Damage and Pain – The Link Which Sometimes Isn’t
The normal way we all understand and interpret pain is that when we get pain we have injured ourselves, there is some tissue damage and this is directly connected to the pain we feel. This is known as the Acute Pain Model, a way of thinking about pain which makes sense to us and overall does a pretty good job. However there are exceptions to this model which can cause difficulties.
Let’s take a look at the Acute Pain Model and the assumptions it makes:
- Acute pain is a recent pain and has nothing to do with how severe or sharp the pain is. From our point of view the fact that it came on recently is the key point. Spraining your ankle during sport or cutting yourself while preparing food are examples of acute pains.
- Pain should convey a message, that’s its function. The message from acute pain is “Warning! Tissue damage has occurred! Do something!”. It’s letting us know that if we don’t pay attention the injury could get worse or not settle down so quickly. Pain protects us by forcing us to take action.
- Pain is important and if we can’t feel pain there is a problem. Some people are unable to feel pain at all and while many of us might think “Great!” this is actually a very bad thing. Such people can’t tell when they’ve injured themselves and this leads to many problems and damaged joints.
- When we get the pain message telling us to do something we generally do. The simplest thing we do is just to stop doing whatever has caused the problem, like taking our hand off a hot object. It’s this change in behaviour that the pain is designed to cause so that we prevent further damage and protect the injured area until it heals and we can use it again.
- Taking the right measures means pain reduces and healing proceeds, allowing us to gradually get back to doing activities again.
- As we start using the injured part more and more as time goes by, we steadily return towards normal function for the area of the body.
If we look at the process described above we can ask the question “What do we know about what went on in this acute episode of pain?” The answer is we know a lot about it.
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