What Is Pain Anyway?

As a physical therapist, I deal with pain on a daily basis in one form or another. Back pain,
shoulder pain, knee pain, neck pain, ankle pain... they’re all part of my daily experience. Pain
is such a common experience for most individuals at some point in their lives, and yet the
truth is that so many people don’t know the first thing about what pain actually is. Pain is
mysterious, and for many of us, pain is actually completely and utterly confusing. I’d like to
shed some light on the darkness, tackling the definition of pain one step at a time.

For most of us, pain is a very common part of our lives. We stub our toe, scrape a knee, or get
our finger caught in a door. While it’s certainly uncomfortable, these types of pain aren’t
necessarily pointing to a problem.  What makes pain such a mystery is that it tends to surface in odd ways, at odd times, and sometimes in completely odd places. And yet, there is an explanation for this: our bodies are telling us that something is wrong, but not necessarily what is wrong.

Let me explain. When we feel pain, our bodies are sending signals to the brain from
the area that just got hurt. If you cut your finger, for example, your brain gets told about
it and your finger is instantaneously sore. Similarly, if you scrape your knee, or stub your toe,
it’s fairly easy to gather information about what happened. But what about when you have
chronic back pain, for example? Did you know that the area of the brain responsible for pain gets bigger when it becomes chronic? This is called central sensitization. In other words your body starts misinterpreting the information and paints worse picture than it actually is in reality. Now if you add fear and anxiety on top of the chronic pain you have yourself a perfect storm.

It is precisely this ambiguous nature of pain that is such a big problem for most of my
patients. On a daily basis I hear, “I just don’t know what I did”, or, “I really can’t remember
hurting it”. Pain is so frustrating in this way – if you only knew why it’s sore! The truth is, it’s
difficult to figure out what your body needs from you – did you pull a muscle, damage the
cartilage, or just sit in an odd position? We often can’t know for sure, at least initially.

 One thing remains certain, however: pain indicates a problem. When you cut your finger, the tissue is damaged and your body signals the brain so that something can be done to repair it. In the
same way, if your back or knee hurts, something isn’t quite right and the body is trying to tell
the brain to repair the damage. In the latter example, it’s just that the answer isn’t as clear.
Despite this, though, both scenarios require the painful area to be examined and
rehabilitated.

It’s clear to see that pain is a lot like your internal warning system. If it hurts, the chances
are that something is wrong. In my clinic,  I treat pain as the symptom of an underlying problem.  You may be feeling pain on the right side of your lower back, however the cause may be in the left hip. This is very common. By approaching pain in this way, I make sure to find the root cause of he problem so as to clear up the tenderness and discomfort. Sadly, for many medical professionals, dealing with pain is something that is done back to front. Painkillers and injections are prescribed to mask the pain in the hope that the discomfort will ease in time.

In my experience, this just doesn’t work. The way we need to approach pain is NOT as a
cause of discomfort, but as a SYMPTOM of a particular problem, whether it’s big or small.
The mystery surrounding ‘pain’ is often worsened by the medical industry’s inability to
treat the root cause of the problem. Instead, many medical professionals seek to get rid of
the pain WITHOUT healing the source of the discomfort. It’s completely counterintuitive.
That’s why physical therapy is by far the best way of dealing with gnawing, frustrating,
mysterious pain: we find the root cause of the problem, heal it, and ensure that you maintain
a pain free, active lifestyle.

We all have to deal with pain in one form or another, but remember, one universal truth
remains the same: treat the cause to get rid of the pain. Your body knows exactly what’s best
for you, and the greatest thing you can do for it is to give it the benefit of the doubt. A pain
free life is possible!