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All of us experience pain — there are many levels. It can be as simple as our stomach growling to tell us we're hungry to excruciating pain in our kidneys when our body tries to pass a kidney stone.
There are two broad categories of pain 2. They are:
Nociceptive Pain: In nociceptive pain, tissue is affected and reports this to the brain. It includes things like bee stings, burns, and simple muscle strains to repetitive movement injuries, nausea, and inflammatory arthritis. This type of pain is not always constant, and can change with movement, a particular position, or even when weight is added.
Neuropathic Pain: Neuropathic pain is often described as stabbing, electrical, or burning. A simple example of this type of pain is when you hit your funny bone. But there's nothing funny about neuropathic pain which occurs because of damage to the nervous system from disease or injury. This category is huge and includes many diseases such as multiple sclerosis, phantom limb pain, and sciatica.
Quite simply, the difference in what type of pain you have is in what part of your body is being affected: tissues (nociceptive) or nerves (neuropathic). You can have both, of course, particularly with injuries.
Are there Other Types of Pain?
We might also include a third category of pain which we will just call "other."
Neurological dysfunctions can also be painful in conditions such as fibromyalgia, irritable bowel syndrome, and some low back pain. These conditions sometimes can and do change — both in symptoms and in treatment. As research continues, as well, these dysfunctions are becoming better understood.
"Fibromyalgia is probably a pain system dysfunction, a poorly understood multi-system failure causing widespread body pain (and more), but 'dysfunction' of the nervous system is specifically excluded from neuropathic pain, by decree with the International Association for the Study of Pain (IASP), as of 2011 3. Dysfunction means that fibromyalgia isn’t caused by any (known) damage to the nervous system, but by its misbehaviour, and so it’s not welcome at the neuropathy club." (from The Basic Types of Pain by Paul Ingraham) 4
Sensitization of Pain: What is it?
What is sensitization of pain? Sometimes our bodies over-react to a normal process. For example, our immune system over-reacts in allergic situations, and our nervous system sometimes overestimates a danger to the body. A certain amount of sensitization is good: if we're about to have a medical test, and we know that some pain may be involved, our bodies do a bit of preparing for that.
Sensitization only becomes dysfunctional when it is chronic and disproportionate to what is actually happening in the body. There will always be a grey area between what we call "normal" and what we call "dysfunctional".
When you see a massage therapist or a physiotherapist, you might be asked to measure your pain between 1 and 10 with 10 being the worst. But everyone feels pain differently, and it is impossible to know if a "10" for Person A really does feel the same for Person B. That's why they ask you to identify the pain, based on your own experience. None of us can truly understand how much pain someone else is in.
"Sometimes we just don’t understand a problem well enough to classify it. The best example of this is the sensitive spots in soft tissue that so many people have — often referred to as 'trigger points'.... There is a popular hypothesis that they are caused by a problem with muscle tissue, which would make it a clear case of nociceptive pain from a fairly subtle lesion… but it’s just an hypothesis, and some experts have suggested that trigger points are caused by a problem with nerves themselves, which would make them neuropathic. No one actually knows, and it’s not likely to be settled for a long time." 5
Coping with Chronic Pain
Most of us cope with pains that come and go. Whether it be a headache, an injured ankle, or post-surgery discomfort, we know that it will end and we try to find ways of dealing with the temporary pain — everything from taking medication to mindfulness exercises and deep breathing.
Chronic pain is another thing altogether and much more challenging for us to cope with. Here are a few suggestions for ways to cope with chronic pain: 6
- Meditating: This is not for everyone, but if you find this workable, it can be very useful.
- Deep Breathing: There are many deep breathing exercises which will help you to relax and may help you to forget your pain, even if momentarily.
- Reducing stress: Always easier said than done, but pain will be worse if you're also stressed. Find time in your day to relax.
- Exercising: When you exercise, you release endorphins. They help suppress pain and they help to lift your mood. Choose an activity that is low-impact and choose appropriate equipment for your situation.
- Cutting out Alcohol and Cigarettes: Both can make chronic pain much worse.
- Keeping a Diary of your Pain Levels and Intensities: This may help you to understand when your pain is at its worse and how you may be able to control it more.
- Learning Biofeedback: This is a relatively new technique in which you learn to consciously control some bodily functions. It requires that you work with someone who is trained to do this, but there is good evidence that it works — and that it is not too hard to master. During a session, you wear sensors that let you "hear" or "see" certain functions such as your pulse, digestion, body temperature, or muscle tension. The monitors reflect what's going on inside your body and you learn to read the monitor so that you can control the biological systems on your own.
- Getting a Massage: Many find a slow, relaxing massage a very healthy way to relax and deal with chronic pain.
- Eating a Healthy, Nutritional Diet: Your body is an engine that works well if it's provided with the right fuel. Avoid junk food, and concentrate on healthy food instead.
- Finding Distractions: Find ways to distract yourself from the pain. If exercise helps you forget, then all the more reason to do it.
- Practicing Yoga: Some studies have revealed that yoga can assist in reducing some types of chronic pain; however, not all yoga is appropriate for pain relief. Yoga that focus on relaxation, such as restorative and gentle yoga, can be safe and effective for those who suffer from chronic pain. But strenuous styles like ashtanga and power yoga could do more harm than good, depending on the person's condition.
The Final Word: Myths about Pain
If you suffer from chronic pain, there are probably several myths which have been repeated to you about it — either from so-called friends and even by your doctor. Here are some of the most common:
No Pain, No Gain: It was a mainstay of the fitness industry for many years. But no more. We know now that pain is not necessary to achieve fitness. If you suffer from chronic pain, it will possibly hurt a bit to exercise, but it may, in the long run, help you.
It's all in your Head: Pain is a complex problem, involving both the mind and the body, but that doesn't mean it isn't real. Pain is an invisible problem, but that doesn't mean it's all in your head.
You have to live with the Pain: There are many options for pain relief (as already mentioned above). It may not be possible to be rid of your pain completely, but you may be able to reduce its intensity or even have some moments free of pain.
Pain Medication will Fix the Problem: With medication comes complications. Your doctor may suggest a conservative approach and prescribe non-narcotic, non-addictive pain-relief medications. Codeine and morphine may be prescribed if pain is severe, such as when treating cancer pain. Of course, many fear that they will become addicted to narcotics, and thus many will avoid them. This is a personal decision each must make — along with consultation with your doctor.
There are no easy answers. The critical issue is that each person must monitor their own pain, find solutions, and learn to understand their pain as much as possible. It is your body, and it makes sense to understand it as much as possible. Be pro-active and work with your doctor on solutions.
Other related articles:
- Seeing Your Doctor: When Should you go?
- Taking Care of Yourself FIRST
- Genetics and Our Health: How much can we control
- Medications of all Stripes: Use them with Knowledge
- Protecting Yourself at Home: Getting Help when Needed
- Protecting Yourself when Walking Outside: Some General Safety Rules
I am a BCRPA-certified fitness instructor in Vancouver, BC. I teach four classes at the West End Community Centre in Vancouver, BC, mostly designed for the older adult. The Inevitable Disclaimer: Everything published here expresses only my opinion, based on my training and research. What you do with the information is entirely your own responsibility. I am not liable for any injury you suffer that seems to be related to anything you read here. Always consult your doctor before beginning an exercise program. For other articles, return to the table of contents.
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Paul Ingraham's website discusses many painful conditions. ↩