Knowledge Centre

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
More plainly, pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, pelvis, or you may feel pain all over. We can think about pain like a response to what your brain judges to be a threatening situation.

Most would agree pain is undesirable, and something to avoid. However, pain can be beneficial when it signals to us that something is wrong and can be helpful in diagnosing a problem.

Pain has a purpose – to protect you from danger or harm.

• Pain is a normal and important part of the body’s warning system. If you never felt pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment.
• Pain can protect you from danger or harm.

• • By being unpleasant, pain makes you think differently, behave differently, and move differently.
  • It makes you react in protective ways when you are hurt or before you are hurt badly.

Most commonly, pain occurs when your body’s alarm system alerts the brain to actual or potential tissue damage. It is important to recognize that the amount of pain you experience does not directly relate to the severity of injury. This is because the experience of pain is influences by many factors, including weather, mood, stress, and sleep.
There are many myths, misunderstandings, and fears about pain. When pain persists and is negatively impacting your life, it can be difficult to see how it is serving any useful purpose. However, pain hurts because the brain has concluded that you are threatened and in danger. In this way, pain is one of the most powerful protective adaptations that we have.

There are two types of pain:

• Acute pain usually comes on suddenly and resolves within about 3-months. This is your body’s normal response to tissue damage, such as sprains, surgery, or illness. It can often be diagnosed and treated.

• Chronic pain lasts longer, usually at least 3-months in duration (i.e., the time that it takes the body to heal fully from most injuries). Chronic pain is less about tissue damage and more about having a sensitized nervous system where the pain alarm signal is turned on easily. Chronic pain is also related to our individual histories with those people living with trauma or adversity more likely to experience it. Chronic pain may not respond to standard medical treatment and it can be disabling and frustrating to live with.

A Metaphor:

The experience of pain can depend on many factors so a metaphor might be helpful. We can think about how the car beeps when we forget to put on our seatbelt as a safety warning. Typically, when we clip in the seatbelt, the alarm stops. However, sometimes we can clip in the seatbelt and the alert doesn’t stop. The car keeps beeping.
The body’s pain system can be like this. The construction of the pain experience of the brain relies on many sensory cues and is impacted by our individual histories. A message is processed through the brain, and if the brain concludes you are in danger and need to act, it will produce pain. With chronic pain, the pain-sensing nerves send off signals as if there was an instant threat of injury or damage when none exists, just as the seatbelt warning can keep beeping.
Learning to manage our pain means learning to manage our nervous system by teaching our brain that we are safe.

Living with daily debilitating pain is physically and emotionally stressful. Chronic stress is known to change the levels of stress hormones and neurochemicals found within your brain and nervous system; these can affect your mood, thinking and behavior.
There are several ways that the chronic pain associated with these conditions can interfere with your everyday life. It can affect your ability to function at home and work. You may find it difficult to participate in social activities and hobbies, which could lead to decreased self-esteem. It’s also common for people with chronic pain to have sleep disturbances, fatigue, trouble concentrating, decreased appetite, and mood changes. These negative changes in your lifestyle can increase your pain and dampen your overall mood; the frustration of dealing with this can increase risk of developing mental health concerns, such as depression and anxiety. This can make other areas of life like work or relationships more challenging too.

Sleep is among the most common complaints voiced by individuals with chronic pain. The relationship between sleep and pain is complex. The presence of pain may make falling and staying asleep more difficult, and insufficient sleep may increase pain the next day. Further, chronic pain may “lighten” sleep and make it more difficult to return to sleep following awakenings.

Chronic pain can be difficult to understand and manage on an everyday basis. Research shows that getting involved to manage your pain can have a big impact on your quality of life. Self-management refers to the skills and behaviours that you can enact to help you live well despite a chronic condition. Self-management doesn’t replace physical therapies, medication, and psychological support, but it can be a big part of feeling better and living a meaningful life.
In the scientific literature, there is no definitive cure for most chronic pain conditions. The goal for treatment of chronic pain treatment is to manage it as best we can. The management of chronic pain generally involves a holistic person-centered approach that addresses multiple aspects of pain and lifestyle. With time and practice, we can retrain the brain to hopefully experience less pain.
Comprehensive chronic pain self-management can target the diverse array of factors that influence the experience of pain, including thoughts, feelings, behaviours, physical activity, communication, sleep, and more. A range of resources for chronic pain self-management are available on the Power Over Pain Portal. We encourage you to browse the resources to learn more.