Pain Management – “Ouch!!! It hurts so bad!”

February 4, 2018 | By | Reply

What is pain?

Pain is an experience. It is what the brain perceives, rather than what is reality. Pain can be either be Acute or Chronic or it can be Adaptive or Maladaptive.

Acute pain is a pain that lasts for a short duration. Chronic pain is pain that lasts for more than three months.

Adaptive pain or good pain Maladaptive pain or bad pain
Promotes healing Abnormal function of the brain processing
Protective Pain or disease
Favours survival Not functionally helpful
Typically short acting Typically long acting

Why do we experience chronic pain?

When the pain lasts for more than three months, there is an error in the processing and interpretation of the pain by the brain. For example: When the CPU of the computer does not interpret data correctly, the input given to the computer will be incorrectly processed. Similarly, the pain in our body has been long lasting, the brain perceives a greater intensity of the pain than its actual intensity. This is Chronic Pain Syndrome (CPS) which can occur in a number of people.

What causes CPS?

  • Prolonged joint problems
  • Chronic back pain
  • Cancer
  • Irritable Bowel Syndrome (IBS)
  • Repetitive stress injuries
  • Nerve damage

People suffering from CPS can experience the following:

  • Anxiety
  • Depression
  • Decreased sleep
  • Weight gain
  • Irritability
  • Feeling of tiredness
  • Guilt

Our brain has past memories that we experience and mimics a similar response in relation to the pain felt in a similar situation.

For example: A person had gone on a walk down the hill and felt a prick in his feet. Thinking it’s a twig he ignored it, and the next memory he has is of waking up in the hospital. The doctor told him he just got saved in spite of being bit by a poisonous worm. Years later he went down for a walk and felt a similar prick. He got anxious and immediately rushed to the hospital thinking it was the same worm again, and to his surprise it was a twig. This shows how our brain maps and has memory of past pain felt or perceived.

People with chronic pain or those who are sensitized centrally should be managed in a different way.

Strategies to overcome pain

Most people deal with pain in the following way:

Pain should actually be dealt with in the following way:

As physiotherapists, we at PhysioRehab have a holistic approach towards our patients. We not only treat the mechanical pain of the patient but we aim for the overall well-being of the patient.

  • Distraction from pain: It activates different channels in the brain and reduces the intensity of pain perceived by the brain.
    We distract the patients and make them do varied exercises which are both interesting as well as useful.
  • Empathy: It is important to be empathetic towards someone with chronic pain. It gives them a better understanding for dealing with the pain as they believe you too can feel what they are going through
  • Positive thinking has a vital role to play when dealing with chronic pain. It helps the person to cope better with their pain and make it more adaptive.
  • Positive body perception is an important tool to deal with chronic pain. It is important that the patient relaxes the mind which controls the intensity of pain felt. A disturbed body perception increases pain as the body loses its sense of belonging to the area of pain. So we as therapists try to impart a positive body perception to the patients which can further aid their recovery. We encourage the patients and support them both physically as well as mentally to make the process of recovery easier for them.

A combination of a healthy mind, body, and brain is the best strategy to deal with chronic pain.

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