Pain Treatment

All Pain is Real. No matter how much you imagine it…

Pain, Def: unpleasant or hurtful sensation resulting from stimulation of nerve endings. The stimulus is carried by nerve fibres to the spinal cord and then to the brain, where the nerve impulse is interpreted as pain. The excessive stimulation of nerve endings during pain is attributed to tissue damage, and in this sense pain has protective value, serving as a danger signal of disease and often facilitating diagnosis.

Unlike other sensory experiences, e.g., response to touch or cold, pain may be modified by sedatives and nonsteroidal anti-inflammatory drug analgesics or, if unusually severe, by opioid narcotics. If sedatives do not suffice and if the cause of the pain cannot be removed or treated, severing a nerve in the pain pathway may bring relief.

Pain is occasionally felt not only at the site of stimulation but in other parts of the body supplied by nerves in the same sensory path; for example, the pain of angina pectoris or coronary thrombosis may extend to the left arm. This phenomenon is known as referred pain. Subjective or hysterical pain originates in the sensory centres of the brain without stimulation of the nerves at the site of the pain.

Progress has been made in the management of chronic pain.

All pain is real, and for many people it is a debilitating part of everyday life. It is now known that understanding more about why things hurt can actually help people to understand their pain and can help to make treatment more successful.

Physiotherapy and Pain

Physiotherapy is a rehabilitation profession NOT JUST a symptom relieving profession.

The most common symptom mentioned by patients is pain.

However there may be situations where maximising what a patient can do has to be done without a change in symptoms.

Pain itself can be disabling. Minimising / preventing disability is a major goal. It is worth noting the intensity of pain is often not a good “benchmark” for how bad the problem is.

Def: “Disability” – “being less able; fear of moving due to what movement might do (i.e re-injury) can lead to disability. “… It is the reaction of the individual to the pain that is the most important factor in the development of disability” … ” reducing pain will help people avoid incapacity only if it is translated into as near possible return to their pre-injury / pre-pain activities at the earliest opportunity”Watson P (2000) Psychosocial predictors of outcome from low back pain. In: Topical Issues in Pain 2. Gifford L (ed). 87. CNS Press, UK.