What is Pain and What Can You Do About It?

We have all experienced pain, but what have you ever wondered “what is pain?” At its most basic definition, pain is a signal. Pain is your body’s way of communicating with the brain that there is an issue. “Pain is an unpleasant sensory and emotional feeling accompanying existing or impending tissue damage or referenced to such damage.” (Swieboda et. al 2013) It can be a warning of imminent danger, an alarm that indicates damage to tissues, or the check engine light that is stuck on. 

Pain 101 

When you have an incident that could cause injury, the nerves (in this case, mechanoreceptors) in the area of the injury take in information and determine that there is potential for damage. They send signals to the brain that equals “hey, pain!” and the brain, in turn, sends signals back to the body to turn on protections to the area in danger. The protections can be muscle tightening, bracing, and correction of the action you are doing. 

This may make you say “well what about reflexes?” Reflexes actually precede your brain registering pain to make our response time quicker. For instance, when we touch something hot, we move our hand away from the hot thing before we even feel the burn. The alarm signal saying something is hot goes up the chain, but instead of going all the way to the brain for instructions it goes to the spinal cord where there is built-in response instructions that immediately go back to the muscle to say “retreat!” 

The pain I am talking about is called receptor pain, which “may come from external tissues–integuments, skin and mucosal pain–from internal organs (eye, ear, nasopharynx, heart, blood vessels, abdominal organs and pelvis minor). There is also pain in bones, joints, and muscles.” (Swieboda et. al 2013) Chemicals and physical stimuli (swelling is an example) surrounding receptors also can cause receptor pain. 

There is also another type of pain called non-receptor pain. The nervous system generates this type of pain without a receptor, meaning it does not have a stimulus to which it is reacting to. Non-receptor pain results from damage to the nervous system and the pain pathway being activated without a reason. An example of non-receptor pain is phantom limb pain. Phantom limb pain is when an amputee continues to have painful sensations in their removed body part after amputation. Non-receptor pain can also occur with nerve damage. The damage to the nerves causes it to send a faulty signal to the brain, signaling pain.   

There are many parts of the pain pathway in the body, but essentially it goes receptors to spinal cord to different areas of the brain for interpretation. Pain information is sent to the brain through nerve fibers. “There are two types of fibers: Aδ and C, involved in pain transmission. The large one–Aδ fibers, produce sharp, well-defined pain, which is typically stimulated by a cut, an electrical shock, or a physical blow.” These nerve fibers send quick signals at about 20 meters/second. 

“The smaller C fibers transmit dull burning or aching sensations. C fibers are very thin and susceptible to damage. The conduction of painful stimuli [along C fibers] is very slow around 0.5–2 meters/second. Numerous C fibers are combined in a ‘net’ therefore, the area covered by branching C-fibers is usually broad, and the patient is able to locate the pain only approximately. C fibers react to mechanical, thermal, and chemical stimuli.” (Swieboda et. al 2013) 

 At the evolutionary level, pain is useful for survival. Being able to quickly signal the brain to take action in the face of injury and danger was developed over time by increasing the chance that we avoid death by feeling pain. “The adaptive value of pain is demonstrated, often tragically, by syndromes of pain deficiency. People born with no capacity for experiencing pain accumulate increasing tissue damage, especially to their skin and joints, and they fail to get full defense against diseases and trauma. The result is deformity, mobility problems, and early death.” (Nesse and Schulkin, 2019) 

One of the unusual things about pain is that we do not currently have a scan or test to determine what someone’s pain level or experience is other than asking them. For many other senses, we can test for it like vision or hearing. Pain is a very complex process within the brain itself, and almost all areas of the brain are involved.  

Chronic pain differs vastly from acute pain. Acute pain is often a one-time sudden signal, or pain that lasts for only a few days. Most often, chronic pain is defined by lasting 3-6 months or more. When our brain experiences prolonged pain, it changes to better manage this stressor. Chronic pain is more complicated to control because of the involvement of many different factors, including stress, sleep, and inflammation “Pain is individual for each person. Pain affects both our previous experience of pain and psychosomatic conditions, depending on the relationship between the psyche and the body” (Swieboda et. al 2013). 

Managing Pain 

Now that you understand what pain is, what are some actions you can take to manage it? 

1. Over-the-counter medications - Your local drug store has an entire aisle designated for pain relief and first aid. Discuss with your physician the best options for you and follow the instructions on the label.
   
   
2. Expert help - Experts on pain and pain relief, like physical therapists, are your best bet for tackling issues with your muscles, joints, and connective tissue. Physicians are the people to go to for organ-based pain. 
   
   
3. Heat/Ice - Heat and ice are a surprisingly controversial topic in the physical therapy and athletic training worlds. The intention of heat is to open the blood vessels and allow more blood to flow to the affected area. The intention of ice is to close the blood vessels and decrease the amount of blood and fluid in the area. It is not well proven that heat and ice do this to the extent that would cause a large effect. There are many opinions of which is better, but choose whichever feels best to you. The most important things to keep in mind with ice and heat, is to use ice for the first 48-72 hours of an acute injury, make sure to protect your skin so you do not get frostbite or burns, and monitor your reaction to the heat and ice by starting with a few minutes checking your skin and then continuing with more time up to 10-15 minutes. 
   
   
4. Stretching - Light stretching can not only decrease tightness, but it can also tell your body to relax. Relaxation helps decrease pain and helps you manage pain. If you have questions about which stretches to do, find an experienced professional to help design a program fit just for you.
   
   
5. Meditation  - Calming and clearing the mind can encourage total body relaxation as well as mediates factors that influence pain outside of the stimulus affecting the pain receptors. Next time you have a sharp twinge of pain, sit down, clear your mind, take 5 deep breaths, and then reevaluate the level of pain you are experiencing.
   
   
6. Bonus! Swearing - Fun fact: swearing has been shown to help us deal with pain and decrease the intensity. So next time you stub your toe, let that F bomb fly! 

Many of you may be thinking, “I have done all of these things with no relief!” We encourage you to look for alternative methods to pain relief and improving health. Traditional medicine may not be the answer for you. Holistic medicine is a realm that is ready to approach pain in a brand-new way with brand-new options. Never give up on finding your solution. 

Resources 

1.     Świeboda, Paulina & Filip, Rafał & Prystupa, Andrzej & Drozd, Mariola. (2013). Assessment of pain: types, mechanism and treatment. Annals of agricultural and environmental medicine: AAEM. 0(1). 2-7. https://www.researchgate.net/profile/Mariola-Drozd/publication/263543237_Assessment_of_pain_types_mechanism_and_treatment/links/53d2b8560cf2a7fbb2e9aff9/Assessment-of-pain-types-mechanism-and-treatment.pdf 

2.    Nesse, R. M., & Schulkin, J. (2019). An evolutionary medicine perspective on pain and its disorders. Philosophical Transactions of the Royal Society B: Biological Sciences, 374(1785), 20190288. https://doi.org/10.1098/rstb.2019.0288 https://royalsocietypublishing.org/doi/full/10.1098/rstb.2019.0288 

3.     https://www.healthline.com/health/pain-relief