Why do we have pain?
It has been crammed into our heads that if we are in physical pain, that something must be “wrong”, or “off”, or “out-of-wack” in our bodies. Granted, if you fall and break your elbow, odds are you will have pain to pair with your newly fractured ulna. In this blog, I am going to share with you 3 stories, and with that, reference 4 people who changed the way I look at pain.
Story 1: A year or two ago during a pain course, the instructor (Dr. Antigone Vesci) showed us a Youtube video. In this video was a man named Lorimer Moseley. Professor Moseley is a pain researcher at the University of South Australia. Now, I do not have the story telling capabilities nor the pain research background that Professor Moseley has, so I will make this brief and to-the-point. He essentially tells a story of a man (himself) who is walking in the “bush” when suddenly he felt a mild prickling pain in his foot. Within seconds, his body informed him that it was probably just a twig and he moved on, soon forgetting about the brief moment of discomfort. Minutes later, he passed out. Well, Professor Moseley had been been bitten by a poisonous snake and luckily survived the incident.
Months later, he was out in the bush again when suddenly he felt the most excruciating pain in his foot. It was NOT mild, it was “absolute agony” and felt like “minutes” of “screaming pain.” When Professor Moseley looked down at his foot (expecting to see a snake bite), he saw a small scratch from a twig. What happened? Why did he experience almost zero pain from the deadly snake, but “screaming” pain from a twig? Because of his PERCEPTION. In the first case, Professor Moseley PERCEIVED the sensation as non-threatening, and hence his body agreed. In the second case, his body remembered the snake, and gave Professor Moseley the biggest alarm it could muster up. As he explains, the pain in these two stories was completely different, because of “meaning.”
Story 2: I learned of Dr. Adriaan Louw when I took a pain course a year ago. Dr. Louw gave us a life long lesson on pain, and one story he shared stuck with me. He told us of a study that involved a woman with severe low back pain. She was put into a functional MRI machine and was told to perform a certain type of motion to elicit her pain. As she moved, the MRI scanned her brain. The scan revealed all sorts of activity, and hence pain. She was then taken out of the machine and was educated on pain itself (pain perception, pain anatomy, etc). The woman was then placed back into the MRI and was again asked to perform the same motion that elicited the pain before. When they looked at the results, her brain activity had diminished significantly. Why? What is happening here? The take home here is humans fear what they do not understand. Once the woman was given a base knowledge of pain, her pain levels lowered dramatically. THIS is cool stuff.
Story 3: An old coworker of mine, Dr. Ake Paramadilok, explained pain to me in a way that I since have not forgotten. Ake educated his patients about pain using a smoke alarm analogy. Sometimes, when we cook food (especially when I cook), we can set off the smoke alarm. The alarm goes off, obviously, because there is smoke, and it is warning us to act accordingly (as it should). However, an alarm can go off when there is no cooking, nor smoke. Why? Maybe a false alarm, maybe a low battery, etc. In this case, smoke is dysfunction/injury, and the screeching alarm is pain. In essence, hurt (alarm) certainly does not equal harm (smoke).
What this blog is NOT telling you: If you have pain, simply ignore it.
What this blog IS telling you: If you have pain, look into it. If your pain is worrying you, see a doctor. However, do NOT stress over pain, understand that perception drives pain levels, and that hurt does NOT equal harm.
Written by Kenneth G. Kells III, DPT