Written by Mitchell Robinson

So far, we’ve seen that:

• pain is an alarm or danger sensor
• pain is not well correlated with tissue damage
• context alters our sensitivity to pain.

Let’s further explore our third point.

Pain depends on the balance of danger and safety that you believe you’re in. When information convinces you that you need protection, your danger alarm system will go off and you’ll experience pain. Damage may be a factor, but it certainly is not the only factor. And you can have ongoing pain without tissue damage - both pain and damage can exist without the other.

"...doing things you enjoy can lessen your pain experience."

An apt analogy can be seen with the low petrol light in your car. When the petrol gets too low a sensor is triggered and a light goes on the dashboard. By itself, this is relatively insignificant – it’s the person driving the car who adds meaning to the signal, interprets it and decides what to do about it. Some of us freak out and race to the nearest service station. Others are far more relaxed, ignore it and carry on for miles. The response probably depends on if you’ve run out of fuel and been stranded before! This is what happens with pain signals from our body. It depends on how they’re interpreted, which can be affected by lots of things including our context and previous pain experiences (Schaible, 2007).

Another great example of this was seen when Rabbitohs forward Sam Burgess played 80 minutes of the 2014 NRL grand final with a fractured face.

Speaking after the 30-6 win over the Bulldogs that broke a 43-year premiership drought with the right half of his face swollen and purple, Burgess said he couldn’t really feel any pain from his fractured face whilst on the field but knew it was broken straight away. “To be honest I couldn’t feel the pain, my head was a little bit dizzy, a bit of blurred vision in the right eye… a few of the boys recognised early on I’d damaged my face,” Burgess said. Asked if he contemplated leaving the field, he said: “We worked for this day from the first of November so there was no chance of me missing out”. Asked if the pain had now kicked in with the game over, Burgess simply said “yep”. (Kennedy, 2014)

The Sam Burgess illustration is a good example of how context affects acute pain. However, the same thing can occur with chronic (long-term) pain. Long-term pain often means that you and your nervous system have become sensitised. This ongoing sensitivity can come from many different sources, including depression and anxiety, wrong beliefs about exercise, fear of movement, a low sense of control, stopping doing things you enjoy and unhelpful coping strategies.

When we think about pain, we tend to think about damage. However, we’ve seen it’s not that simple and pain often behaves strangely. Just like stressors in your life can make your pain experience worse, doing things you enjoy and things that are meaningful to you can lessen your pain experience. Exercising, resuming hobbies that you enjoy and going out with friends are all things that can make you less sensitive to pain.

If you’re struggling with pain and think you would benefit from seeing a physiotherapist for your pain management, talk to your GP. Sycamore Health has a speciality in pain management and non-medicated remedies, and would love to help you take control of your pain!

Next part in this series: What You Need To Know About Pain: Part 5

References:
Kennedy, C. (2014). Burgess couldn’t feel pain from fractured face. Retrieved from https://www.nrl.com/news/2014/10/05/burgess-couldnt-feel-pain-from-fractured-face/
Schaible, H. (2007). Peripheral and central mechanisms of pain generation. Handbook of Experimental Pharmacology, (177), 3-28.