What is pain?
Pain is an uncomfortable feeling that tells you something may be wrong. The International Association for the Study of Pain’s widely used definition defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”.
It is one of the body’s most important communication tools. Imagine, for instance, what would happen if you felt nothing when you put your hand on a hot stove. Pain can be mild or severe, and it serves to motivate the individual to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in the future. Pain can be dull, sharp, throbbing, burning , and may result in trouble sleeping, mood changes, weaknesses and a lack of energy.
Pain is not just a physical sensation. It is influenced by attitudes, beliefs, personality and social factors, and can affect emotional and mental well-being. Although two people may have the same pain condition, their experience of living with pain can be vastly different. It can significantly change a person’s lifestyle and impact one’s job, relationships and independence.
Pain is usually transitory; most pain resolves once the noxious stimulus is removed and the body has healed, but it may persist despite removal of the stimulus and apparent healing of the body. Sometimes pain arises in the absence of any detectable stimulus, damage or disease.
Types of pain
There are several ways to categorize pain. One is to classify it into acute pain and chronic pain.
Acute pain: This typically comes on suddenly and has a limited duration of about 3 months. It’s frequently caused by damage to tissue such as bone, muscle, or organs. It acts as a warning to the body to seek help. Although it usually improves as the body heals, in some cases, it may not.
Acute pain can transition into chronic pain if it is untreated or poorly treated. The longer pain remains untreated, the greater the risk of the pain becoming chronic. Therefore timely and effective treatment of acute pain is essential to prevent it from becoming chronic.
Chronic Pain: In this type of pain, the body keeps hurting weeks, months, or even years after the injury. Chronic pain lasts beyond the time expected for healing following surgery, trauma or other conditions.
It is generally somewhat resistant to medical treatment and can exist without a clear reason at all. Although chronic pain can be a symptom of other disease, it can also be a disease in its own. Some of the leading causes of chronic pain include past injuries or surgeries, back problems, migraines and other headaches, arthritis, nerve damage, infections, fibromyalgia (a condition in which people feel muscle pain throughout their bodies).
Statistics and impact
Pain is a major symptom in many medical conditions, and can interfere with a person’s quality of life and general functioning. Chronic pain is considered a health crisis due to its high prevalence and associated physical and emotional incapacity. A multi-center study carried out in 1998 by the World Health Organization (WHO) has shown prevalence of chronic pain in 22% of the world population, and 25% of people with chronic pain lose their jobs.
It is estimated that chronic pain is one of the major causes of disability in many regions of the world, in developed or developing countries, and may inhibit people’s ability to carry out labor and daily activities, in addition to impairing their mobility.
Most significantly, it can change your lifestyle and impact your job, relationships and independence.
The role of Physiotherapy
Physiotherapy can be highly effective for all types of chronic musculoskeletal and neuropathic pain. The physiotherapist, as part of the multidisciplinary team, plays a key role in the management of pain by helping people develop the skills they need to manage their condition, increase their activity and improve their quality of life. The physiotherapist assesses a patient’s condition and difficulties, gives advice and offers a physical treatment. The physiotherapist takes into consideration the combination of factors affecting the patient, and develops an individualized treatment plan.
There are three basic foundational components of physiotherapy treatment and/or management for individuals experiencing chronic pain. These are:
• Education on the assessment findings
• Improving function, activity, and overall quality of life
• Promoting self-management of condition to minimize its effects
Exercise and chronic pain
Exercise is one of the best pain management options for chronic pain. Significant research has shown that exercise is an essential aspect in the treatment of chronic pain.
Appropriate exercise prescription is an important component of optimizing function and mobility in people with chronic pain.
The less you move, the more pain you’ll experience. Conversely, the more safe, therapeutic activity and exercise you get, and the more you learn how to exercise to accommodate your pain, the less pain you’ll feel and the more you’ll be able to function on a daily basis.
Regular therapeutic exercise will help you maintain the ability to move and function physically, rather than becoming disabled by your chronic pain.
Exercise strengthens muscles. The stronger your muscles become, the less intense your chronic pain is likely to feel.
Exercise ensures your joints keep moving well. For patients who suffer from chronic pain associated with arthritis, the best way to minimize discomfort is to restore motion to the joints.
It helps you maintain a healthy weight, lose weight and avoid obesity. Extra weight can add to your pain, particularly if you have chronic back pain.
Exercise restores your pain threshold. Research has proven that an active lifestyle increases your pain threshold.
Exercise improves mental health. Chronic pain patients often struggle with depression, anxiety, and other mental health issues due to difficulties tying to live life as they once did. Exercise produces immediate antidepressant and anxiolytic effects– that is, it makes you happy! Exercising also can give you a sense of better control of your pain.
Both acute and chronic pain can be debilitating, and both can affect and be affected by a person’s state of mind. But the nature of chronic pain — the fact that it’s ongoing and in some cases seems almost constant – makes the person who has it more susceptible to psychological consequences such as depression and anxiety. At the same time, psychological distress can amplify the pain.
Talk to a physiotherapist about what type of exercise would be good for you. You need to take into account your pain, fitness level, and activities you enjoy. A physiotherapist, the exercise expert, can help you develop a regular exercise plan that you can stick with—one that isn’t overwhelming.
By: Pokuaa Christiana (A Senior Physiotherapist; Health Promotion Officer
Effia Nkwanta Regional Hospital, Sekondi)
Email: [email protected]