Pain Science: Rethinking How We Experience Pain
Pain is a universal human experience, yet it remains one of the most misunderstood aspects of health. Traditional views often equate pain directly with physical injury, but modern pain science challenges this simplistic understanding. Pain is a multifaceted phenomenon involving sensory, emotional, and cognitive factors. This perspective advocates for a holistic approach to pain management, emphasizing the nervous system's role and empowering individuals to retrain their pain response.
Pain and Injury Are Not Always the Same
Most of us can think of a time when we had an injury but no pain. Maybe you noticed blood on your body when out gardening, only to see a significant cut on your arm, or waking up and noticing a large bruise on your body, and you don’t recall what caused it. Sometimes, pain may have emerged after you saw the cut or bruise, but not when the injury happened. The opposite side further exemplifies the disconnect between pain and actual tissue damage: we can use the example of phantom limb pain, where individuals experience pain in a limb that no longer exists. These examples highlight that pain is not always a direct indicator of physical damage. In the first situation, we have injury and no pain; in the second, we have pain with no injury.
Pain as a Complex, Multidimensional Experience
Pain is not a simple signal proportional to the extent of tissue damage. The pathway of sensory information from the body travels to multiple areas of the nervous system, including the somatosensory cortex (for location and sensation) and the limbic system (for emotional processing). This interconnectedness underscores the sensory and emotional components of pain, making it a complex experience.
The Brain's Role in Predicting and Protecting
The brain plays a crucial role in interpreting signals and predicting potential threats, which can influence the experience of pain. For instance, gently stretching your finger backwards can cause discomfort before actual tissue damage occurs – a protective mechanism. Chronic pain often results from an oversensitive or overprotective nervous system, where the brain's predictions sensitize the pain response. People are not faking pain, and the pain is not made up in their head; the nervous system actually changes to make it more sensitive. Think of it like the motion detection lights outside your house, the sensitivity dial has been ramped up, a leaf falls off your neighbor's tree, and your lights go on, it is overprotective. Your brain also uses more than just sensory information to process pain or potential threats. Psychological factors (for example trauma, fear, thoughts, and emotions) and sociological factors (such as environment, stress, and lifestyle) interact with biological factors (immune and endocrine systems) to shape an individual's pain experience.
Understanding Pain is Crucial for Recovery
Understanding that pain doesn't always mean your body is damaged and that your sensitive nervous system can be retrained empowers individuals to challenge limiting beliefs and actively participate in their pain management. It involves a holistic approach, including improving lifestyle factors (diet, exercise, quitting smoking, etc.), addressing psychological factors (decreasing stress, reframing negative thoughts, and more), and promoting movement and daily activities.
Understanding the complex nature of pain empowers individuals to actively participate in retraining their nervous system to reduce the impact of chronic pain and improve overall well-being.
Kory Zimney, PT, DPT, PhD is a professor at the University of South Dakota, School of Health Sciences Physical Therapy Department and director of the PhD in Health Science program. He received his Master of Physical Therapy from the University of North Dakota in 1994. He completed his post-professional Doctorate of Physical Therapy from Des Moines University in 2010 and graduated with a PhD in Physical Therapy from Nova Southeastern University in 2020. Dr. Zimney is part of the Center for Brain and Behavioral Research at the University of South Dakota and the Therapeutic Neuroscience Research Group conducting research specifically in the areas of pain science and therapeutic alliance. Understanding Pain and What to do about it | Kory Zimney | TEDxUSD. Follow The Prairie Doc® at www.prairiedoc.org, and on social media. Watch On Call with the Prairie Doc, most Thursday’s at 7PM streaming on Facebook and listen to Prairie Doc Radio Sunday’s at 6am and 1pm on SDPB Radio.