We can’t avoid it. At some time or another, most of us will experience pain of some sort that could potentially be debilitating. Some individuals tolerate pain much better than others. But why is this so? And where is the pain originating? Can it be that it is all in our head?What is pain?
Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage,” according to The International Association for the Study of Pain. So based on this definition, pain can arise from actual injury to a tissue (i.e., muscle, tendon, bone) or the potential for injury to a tissue. Regardless of whether the damage is actual or potential, one thing is certain–individuals will perceive pain as real!How is pain understood?
Pain is one of the main symptoms causing an individual to seek medical help from a Physical Therapist or other health care professional. But our understanding of what pain is, why it occurs, and where it originates has changed significantly over the past 8-10 years. 10-15 years ago it was thought that pain originated at the level of the tissues (e.g. if you hurt your elbow, pain signals originated at the level of the elbow). It is now generally thought that pain is not perceived until the brain concludes there is a potential threat to those tissues. In other words, if you injure your elbow then danger signals originate at the level of the elbow. Those pain signals are then relayed to the brain, and the brain determines if it needs to respond by sending an output of pain. And this response is extremely individual, meaning what causes one individual’s brain to respond may not cause another’s to do so.
As a result in this shift in pain perception, the approach to how Physical Therapists determine your care has changed as well. While many health care fields focused on the treatment of individual tissues in the past, many Physical Therapists are starting to adopt a bio-psycho-social model of pain treatment. This means that Physical Therapists will no longer focus solely on the tissues of the body (bio), but now also account for psychological and social factors that can be influencing the amount of pain you are experiencing. This would include incorporating aspects of work or sport into your rehab program (assuming you injured yourself at work or participating in a physical activity), as well as discussing any fears you may have regarding movement, and helping to give you the confidence to once again move safely.How is pain described?
We know that everyone perceives pain differently. Even though Physical Therapists attempt to “quantify” the pain by having the individual assign a number to the intensity of pain one is experiencing (“rate your pain level on a scale of 0 to 10, with 0 being “no pain” and 10 being “emergency room, call 911” pain), pain is still subjective–what is labeled a “7/10” pain by one person might be labeled a “3/10” pain by somebody else. We often hear people say “I have a high pain threshold,” but because pain is subjective, science has not developed accurate ways to measure pain tolerance.Read the entire article