Understanding Pain

Written by Natasha Clarke, DPT


Do you feel general pain?

Strong man with neck pain, back view

Pain in general can be difficult to explain to others, and sometimes patients experiencing chronic pain are faced with colleagues or loved ones that don’t understand. You know that when you stub your toe that pain will usually follow, but why is it that it sometimes lingers on? Have you ever wondered why we feel pain?

Pain is a signal to your brain that something is not right. Nerves throughout our body send information about what is happening in our environment to the brain through the spinal cord. The brain then sends information back to our nerves, helping us to perform actions in response.

Acute pain vs. chronic pain: There are two major categories of pain: acute pain (short-term) and chronic pain (long-term).

Acute pain is a severe or sudden pain that resolves within a specific amount of time. You might feel acute pain when you experience an injury, have surgery, or are sick. An example of acute pain is when you sprain your ankle. The nerves in your ankle respond by sending signals to the central nervous system (your spinal cord and brain) to let them know that something is wrong. The brain then decides how bad the injury is and what to do next. Think of your brain as an extensive database stored with every event like this in your life. Your brain decides whether to invoke tears, raise your heart rate, release adrenaline, or perform one of a million other possible responses.

With chronic pain, however, the initial pain receptors continue to fire after the injury. Chronic pain is generally defined as pain that lasts more than three months. Chronic pain can be caused by a disease or condition that continuously causes damage such as arthritis. Sometimes though, there is no longer a mechanical cause of pain, but the pain response is the same. In these cases, it is difficult to pin down the cause of the chronic pain and thus difficult to treat.

What influences pain? Each person’s response to pain is unique. Because pain messages pass through the thought process regions of your brain, your experience of pain is shaped not just by the physical stimulus, but by psychological, emotional and social factors as well. Memories of past painful experiences, genetics, health problems, coping strategies, and attitude towards pain can all contribute to how you feel pain and how your brain decides to respond.

What should I do about chronic pain? Research has shown that movement is one of the most effective ways to treat chronic pain. Although many people are initially fearful of motion, physical therapy and exercise that is slowly reintroduced is key to managing chronic pain. A Physical Therapist can analyze an individual’s total pain picture and provide services that allow you to better manage your pain, as well as restore your mobility and function.