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Essential Knowledge About Pain

“My pain does not equal damage”

Watch This Video. The back is being stimulated by a soft fibre, like a piece of fishing line.

WHAT DO YOU THINK THIS VIDEO MEANS: This is allodynia, where something that would not usually be perceived as pain, is painful. For this person, light stimulation on the right side of the back is perceived just as light touch. On the left side though, the stimulus is perceived as pain with visible associated muscle spasm.

In This Video, Pain Does Not Equal Damage

IMPORTANT FACTS ABOUT HOW PAIN STARTS: Body systems heighten messages for pain perception.

  1. The primary purpose of pain is to protect us.
  2. Pain is defined as a sensory and emotional experience. How people react in a sensory sense depends on the individual and the situation. Your pain can’t be judged against another persons pain (to see how different people respond differently to the seeming same stimulus, try our Facial Expressions of Pain Project). And it is the emotional aspect that may largely dictate the level of pain you experience, not damage.
  3. When you first have an injury, pain is part of a process that lets your body know that it should start the healing process and in the immediate phase perhaps rest/protect the affected area. This may happen suddenly (reaching down to lift a box) or gradually (repetitive use of the arm over many days).
  4. At this early stage, the body systems that facilitate pain perception ‘wake up’. This can heighten your response to all stimulus. For example, when you have an acute sprained ankle, there may be allodynia (pain with light touch) and hyperalgesia (when something that might usually be experienced as pain is far more painful than expected). Even at this stage pain does not always equal damage.
  5. From where there is a stimulus (like trying to walk on a newly sprained ankle), to where the brain perceives pain, and anywhere in between, pain can be amplified.

IMPORTANT FACTS ABOUT WHAT HAPPENS NEXT: Body heals but messages stay heightened

  1. In the vast majority of cases, musculoskeletal injuries heal within 3 months (see the Return To Work section for example), though in some specific circumstances this process may take longer (e.g. true nerve pain when a herniated disc is impinging on a nerve). During this time body systems that have been ‘woken up’ to heighten the pain experience, ‘go back to sleep’. The experience of pain settles accordingly.
  2. Sometimes, once the body has healed the injury, the brain can continue to interpret stimulus as pain. The body systems that lead to the experience of pain stay ‘awake’ and ‘on alert’. Processes like allodynia and hyperalgesia continue, and trick the brain into perceiving pain.
  3. There are many reasons for this. Other sections of this web site can help you explore what factors may be relevant to you.
  4. When pain is ongoing, the brain can start to misinterpret threat, further heightening pain.

 For more on how pain does not equal damage, read about

“My scan doesn’t dictate my outcome”

spine_scan

Want to learn more about chronic pain?

Watch this 5 minute video


Summary: Pain does not equal damage

Pain is a sensory and emotional experience, designed to protect. At the earliest onset of an injury, body systems ‘wake up’ to heighten messages perceived as pain. When an injury heals, body systems may continue to heighten messages resulting in continued pain. The brain may misinterpret threat, and further heightening pain in an ongoing manner. In all of these situations, pain does not equal damage.

Evidence Informed Information Compiled By Dr Darren Beales, PhD and Dr Tim Mitchell, PhD