Blake H. Tearnan - 10 Simple Solutions to Chronic Pain: How to Stop Pain from Controlling Your Life

Learning more about pain, and specifically about the interrelationship between pain, suffering, and disability, will allow you to better understand your own situation. This is an important first step in learning how to manage your pain and improve your quality of life. Its also the foundation for understanding and implementing all of the solutions in the chapters that follow.

Pain arises from actual or potential damage to the body, motivating people to take action to avoid harm or seek recuperation (Asmundson 1999). Cognitive and emotional factors come into play as the pain information enters the central nervous system. How a person interprets and responds to pain is influenced by the expected threat associated with the pain.

Pain is difficult to define since its something we cant touch or see. Its a subjective experience, and its also basic to our survival. As youll learn, pain is much more than the feeling you get when you stub your toe or burn yourself on a hot stove.

How we define pain is important, since it helps to make this complex experience more understandable, leading to better ways of approaching solutions to the problem of pain. In 1982, pain expert John Loeser proposed that pain consists of four dimensions: nociception, pain, suffering, and pain behavior. Nociception is a complicated-sounding word, but it simply refers to potential tissue damage and injury that excites nerve endings. Think of nociception as the underlying physical mechanism that initiates the signal of pain. The second dimension, pain, is the sensation experienced as a consequence of nociception. Subjectively, you might describe your pain as achy, tender, sore, sharp, stabbing, or burning. Suffering is the negative emotion generated by pain and problems associated with pain, such as stress and various losses. Finally, pain behavior refers to any behavior you exhibit in association with the presence of pain, such as facial expressions, speech patterns, taking medication, asking others for help, and limiting your activities.

Loesers view of pain is a useful starting point. However, the components need to be understood in a broader context, especially with regard to how you interpret and react to pain, and how your pain is affected by various social influences and other environmental factors. In other words, pain is not simply a well-defined response to a physical stimulus registered in the central nervous system and resulting in an uncomfortable sensation. As nociceptive stimulation enters the spinal cord and brain, the signal doesnt travel to a specific pain center. Pain information travels to many areas of the brain involved with interpretation, judgment, and emotions. This is where matters get complex, since distraction, past experiences with pain, fears attributed to pain, perception of coping strength, social support, and a whole host of other factors determine in a puzzling way how pain is experienced and how you respond to it.

Historically, pain has been thought of in purely mechanistic terms. The analogy often used for pain is a rope and a bella jerk of the rope causes the pain bell to ring. However, this is too simplistic. For example, it doesnt account for why people who are anxious experience more intense pain. The experience of pain is affected by a variety of psychological, social, and cultural influences, calling into question the notion that pain can be adequately explained by a wired, mechanistic process.

Acute pain refers to pain that lasts less than three months. Acute pain serves a useful purpose, helping motivate us to take action to protect ourselves. Tissue damage, swelling, and inflammation are characteristic of new-onset pain. Normally, but not always, the extent of the damage determines the intensity of pain experienced. Acute pain is generally responsive to treatment, such as medications. Emotionally, acute pain can trigger feelings of anxiety, which is usually a good thing because anxiety helps motivate us to take action, such as seeking help, monitoring the status of the injury, and being careful to avoid further injury.