A Prickly Situation – the Science & Psychology of Pain

25 May 2020, 11:31AM

Pain is a common condition, characterised by a highly unpleasant sensory and emotional experience.

Everyone will experience occasional aches and pains at one time or another during their life, as pain is one of the body’s natural protection mechanisms. But depending on the intensity and duration of the pain, it may cause discomfort and distress and can potentially be debilitating.

Pain encompasses a broad spectrum of sensations and emotions. Whilst pain is universal, the subjective experience of it is personal and often private. Some pain may be short term (acute pain), while other pain may persist long term (chronic pain). Persistent pain can be a heavy weight to bear and can have a significant impact on all facets of life – from relationships and responsibilities to movement and mood.

As the prevalence of pain and inflammation in society increases, pain relief has become synonymous with popping a pill. The harmful consequences of overusing and misusing pain medications have reached critical levels. Natural therapies, when appropriately implemented, can provide alternatives to, or complement pharmaceutical treatments. Taking a multi-disciplinary approach to pain treatment and building a pain management team of healthcare professionals can help to provide optimal support for your symptoms.

The Science of Pain

Maybe you’ve felt it as a short sharp stab, or perhaps it’s a dull ache. Maybe you feel it in just one body part, or perhaps it’s widespread. It could be ever present, or it could come and go...

Everyone experiences pain differently. This can make it difficult to objectively describe and define, diagnose and measure. Two people with the same pain condition may have distinctly different experiences of living with the pain. So there’s no “one-size-fits-all” model.

However, the widely accepted definition of pain from the International Association for the Study of Pain (IASP), describes it as an unpleasant sensory and emotional experience associated with actual or potential tissue damage.

Pain is complex, in that it is not a single input to the body from a physical sensation. Rather, the brain evaluates and interprets both external and internal information, with the feeling of pain resulting as the output of the body’s “danger detection” system.

Danger!

Pain is the body’s natural, highly sophisticated protective mechanism, designed to keep you alive. Think of pain as your built-in alarm system, alerting you to actual or potential damage from harmful stimuli or perceived dangers, such as heat from a hot stove.

This danger detection system is called nociception. “Danger detectors” are spread through all tissues in the body, and when they identify something potentially harmful via sensory inputs, they send alerts up the spinal cord to the brain with the location and intensity of the threat. The brain evaluates all inputs – both external and internal – and decides whether you need protecting which usually triggers pain.

On a physical level, pain is expressed as an unpleasant feeling in your body designed to compel you to stop and change your behaviour (move away from the threat and protect yourself), since the brain perceives that the stimuli is putting you in danger. In chronic pain conditions, such as persistent muscle soreness, the wiring of your body’s alarm system becomes faulty so that pain signals no longer operate in the intended manner.

A Painful Perception

Pain sensitivity and tolerance levels vary significantly from person to person. This is because your individual perception of pain is generated and influenced by a range of information sources – not simply the external stimulus.

These include the context in which you experience pain; your personality and life experiences that shape your attitudes and beliefs around pain; and your emotional and mental state at the time. Additionally, pain perception can differ from one person to the next due to genetic variations.

Variables that influence perceptions of pain include:

Attention

  • If a person is distracted, they’re likely to feel less pain

Psychological state

  • If a person is anxious, they’re likely to experience more pain

Sleep deprivation

  • If a person lacks sleep, they’re likely to be more sensitive to pain

Gender

  • Women are more likely to experience chronic pain than men

Social & cultural norms

  • In many cultures, men are discouraged from overtly expressing pain

A Picture of Pain

Two main categories of pain are:

Acute Pain

  • Lasts for a short time
  • Occurs following an injury, surgery, trauma or as a symptom of an illness
  • Can be caused by structural, tissue or nerve damage
  • Acts as the body’s alarm system, designed to compel you to move away from danger, protect yourself from further harm and seek help
  • Usually becomes less severe as the injury or condition heals
  • Can transition into chronic pain if left untreated or poorly treated

Chronic Pain

  • Usually lasts longer than 12 weeks
  • Persists beyond the expected healing time of an injury, surgery, trauma or symptom of a disease
  • Can also be a stand-alone condition and exist without a clear reason
  • Characterised by changes to the central nervous system

The Psychology of Pain

Pain can be divided into primary and secondary pain.

Primary pain

  • Primary pain arises from damage to the body or nervous system, or from illness or disease and is the “unfiltered information” sent from the body to the brain.

Secondary pain

  • Secondary pain is the brain’s reaction to that unfiltered information. It’s controlled by an amplifier in the brain that can dial up or dial down the overall intensity of your pain – and consequent suffering.

Often, before you’ve even consciously registered the pain, it’s been heavily processed by your brain to come to its evaluation.

Putting your pain under the microscope, your mind picks apart all the different sensations you’re feeling, trying to identify the underlying cause to find a corresponding solution so that you can avoid further pain. As your mind searches for patterns or clues, it brings to mind memories of when you have felt similar pain in the past – in doing so, amplifying your pain in the present.

If you’ve suffered from pain for some time, you may have plenty of painful memories to draw upon, but few solutions which can increase anxiety about your situation. These negative thoughts feed back into your body, fuelling your tension. This vicious cycle can begin to create a well-worn path in the mind, so that you become more sensitive to pain in a futile bid to try and avoid it.

In fact, brain scans have shown that people who suffer from chronic pain have more brain tissue dedicated to feeling the conscious sensations of pain. If you find yourself in this situation, it can be important to seek the advice of a healthcare professional.

No Brain No Pain

If you didn’t have a brain, would you still feel pain?

While you feel pain in your physical body, it’s your brain that’s behind it. Your brain can turn on or turn up your pain, based on any credible evidence that suggests your body is in danger and needs protecting. Conversely, increasing evidence of your safety and security can help your brain dial down the pain. Understanding how pain really works, cognitive behavioural therapy, practising mindfulness and relaxation, moving your body safely and other coping strategies can all help cultivate a greater sense of safety.