Saturday, 8 August 2015

What is Pain? Part Two: The Pain Alarm

Believe it or not, pain is very useful.  It is a wonderful thing that our bodies are capable of feeling pain. Acute pain is protective, needed, and serves a purpose. Imagine a toddler exploring the world without pain - that child would sustain an unbelievable number of injuries while experimenting with different ways of moving, with no indication that any of these movements could be dangerous. The protective nature of pain can also be seen with conditions that affect sensation, such as leprosy, diabetes, and quadriplegia. In these conditions there is a loss of protective sensation that can result in serious injuries and wounds. The following diagram is a simplified version of what happens in the body and brain when pain is experienced. The painful stimulus is recognized and our body reacts in order to protect itself.
However, there can come a point where pain stops being useful,and it turns into something far less helpful, and even insidious. Chronic pain is pain that is no longer protective. Sometimes chronic pain may be linked to actual damage in the body, such as in conditions like arthritis or cancer. Other times, there may be no obvious physical reason for the pain to persist “If acute pain is Dr. Jekyll, then chronic pain is Mr. Hyde. It is the body’s alarm system gone amok.” (Richeimer, 2014, p.2)

Another way to think of it is that acute pain is like a fire alarm, loudly informing you that there is a problem that needs to be addressed immediately. Chronic pain is like the fire alarm is malfunctioning - sounding regardless of whether there is a fire, or continuing to alarm long after the fire has been put out (Thernstrom, 2010). Even though this alarm is not signaling immediate danger, it is very real and can be so loud and overwhelming that it leaves you unable to function or focus on anything else. It can be undeniably disruptive to everyday life. There are many theories to explain why the alarm may become dysfunctional. This diagram demonstrates a few of them.

Unfortunately, chronic pain isn’t as easy to “fix” as a broken alarm would be. For a broken fire alarm, you would simply unplug it, or call a repair technician.  If chronic pain is telling us our system is out of whack, we need to figure out why and then work to solve it, which is no easy task! To fix the misfiring alarm you may need a team of “repair technicians” - a physician, pharmacist, physiotherapist, occupational therapist, psychologist, and other team members. Even with all these people on your side it is still possible that there will be no way to silence the alarm. Managing chronic pain is like reducing the volume on the alarm and learning how to function while it’s still sounding.

We firmly believe this is possible and achievable. Chronic pain changes life, but it doesn’t have to define it. There are no overnight solutions, but there are a variety of strategies that can lessen pain symptoms and improve the ability of an individual and their family to function. What are your strategies? What has worked (or not worked) for you? Please feel free to share your thoughts with us through the comments below or email us. We look forward to discussing these in future posts.

Thank-you for. coming along on our journey as we work on fixing the broken alarms in our own lives. We hope this blog can create a community where we can inspire each other to live the best possible versions of our lives. 

Acknowledgements

Diagrams by Reclaiming Life. Brain graphic from Freepik.com
References
Richeimer, S. (2014) Confronting Chronic Pain. Baltimore, Maryland: John Hopkins Press.
Thernstrom, M. (2010) The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering. New York: Farrar, Straus, and Giroux.

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