What does pain mean to you?

Pain is always a very difficult topic to discuss. So many people describe pain in different ways and pain itself and the idea of what it truly is, how its perceived and what we should do when we experience, especially in terms of injuries or activity, seems to change on a regular basis. For a long time therapists use to chase the pain finding the symptoms of pain, leading to initial short term improvements but never caused the pain to fully leave or the true cause to be chased down and dealt with. We as humans became heavily dependent on getting rid of pain so we could function long enough to compete or just get through the day. this lead to many people suffering in the long term, with tissues being damaged and movement patterns leading to injuries merely being ignored instead of changed.  The international association for the study of pain describe pain as “An unpleasant sensory and emotional experience associated or as a result of actual or potential tissue damage”.

In certain sports they have become dependent on the idea of deal with the pain to allow an individual to compete for a long enough period and then to essentially come off injured. American Football is the worst culprit for this and still continues to chase the symptoms instead of the cause.  Sadly leading to the abuse of NSAIDS, painkillers normally injected into an affected area but the overuse of which can cause tissue degeneration. Other sports have already moved away from such methods but often we find ourselves stuck in a situation where we have an athlete asking to play and willing to push through an injury, coaches balancing their want for player safety and need to produce results and therapists stuck between the want of their patient and the knowledge of what is truly occurring to them and what will occur with further stress.

People often want a quick solution and don’t want the hassle of consistent or prolonged rehab or activity when a quick solution of masking the pain will allow them to do the same. America alone spends $323 billion dollar in 2015 on pain medication with it likely to increase to $450 billion by 2021. Obviously this includes individuals taking pain medication for conditions that cannot be cured through rehabilitation and activity but a huge sum of this money is towards people suffering chronic but curable pain as well acute pain due to musculoskeletal injuries or tension.  Looking then to the entire world the money spent on short term relief of pain is astronomical in comparison to the price of what rehabilitation or increased levels of activity cost in the long run. 

The issue with always masking or reducing pain is that pain is not always a bad thing. Pain normally allows for us to find the cause or the issue or the reason behind injuries. It also allows us to prevent ourselves from returning to a position where our tissues cannot, at that time, deal with the loading asked of them.  Pain is a way for your body to protect itself by trying to force us out of positions or activities that is causing damage or this sensation to be produced. Pain not only causes physical changes but mental as both are interlinked to a level where we often cannot control it. Pain will lead to physical change which will lead to mental changes in the form of a change in movement patterns and the reaction to fear. This is often an unconscious factor but often leads to prolonged changes in the way we function. We can also become over saturated with pain meaning we can become hypersensitive to it or almost numb to its presence, both as bad as the other in functional terms.

Pain can illicit a response from several systems including the motor, endocrine, sympathetic nervous and immune system.  Pain also does not always mean tissue damage in the sense of an injury.  For muscle and tissue to correctly develop it has to be broken down and built up, with the correct loading for more avascular tissues. Pain is also exceedingly selective with pain producing a different  response or level of pain depending on its cause or placement of injury depending on the activities of each person e.g. knee pain in an Olympic weight lifter vs a musician. Our body has specific healing phases with each tissue type having a different time-frame of healing. Masking the pain or introducing exterior stimuli to reduce pain before these stages are complete to an excessive level can cause issues where a premature return to activity occurs several times causing chronic problems.

Our biggest issue stems from a mixture of refusing to spend the time needed on correct rehab to produce long standing results and our lives revolving around excessively sedentary lifestyles. We only need to be active in the correct manor for short periods each day but we find it difficult to entertain the idea of it. Time seems to be the real killer with us normally not having the patience or willingness to give time over to what seems hard to make things easy in the long run, instead doing what is easy and maintaining what is wrong for the long run.

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