In this 3-part series we are going to look at our understanding of pain, how it affects us day to day and some strategies to use when we are in pain.
But before looking at what to do when we are in pain, we must first understand what pain is…
Around 400 years ago and until relatively recently, pain was considered a fairly straightforward process: you damage your body, a message travels up to your brain, and you experience pain, as the popular image from Rene Descartes’ work ‘Treatise of Man’ represents.
Pre-dating Rene Descartes’ work, Aristotle believed that pain could be produced by spirits entering the body. In fact, many scientists theorised that pain was an act of God. So, as you can imagine, this hypothesis has become rather influential.
In the present day, pain is defined by the IASP (International Association for the Study of Pain) as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’.
The majority of people will accept that pain is indeed ‘an unpleasant’ experience, but there are some valuable points in the statement that require a little further thought:
‘An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.’
We will look at the ‘emotional experience’ later, but for now let’s consider the wording ‘potential tissue damage’. This statement implies we need no actual tissue damage to be in pain! I repeat, we need no actual tissue damage to be in pain! In fact the reverse can be true; we can have significant tissue damage and yet not report any pain18.
This can be a difficult concept to grasp, as we are so used to thinking along the Cartesian lines of: ‘If I am in pain something must be damaged’. This is false.
Now before moving on to Part 2 I would just like you to have a little think about this statement:
“Pain intensity and unpleasantness are not simply determined by the magnitude of the painful stimulus but ‘higher’ cognitive activities can influence perceived intensity and unpleasantness.”3
i.e. Hurt ≠ Harm