Continuing Ed Topics: Pain

This post wraps up the current series of continuing education, although I’m sure the next time I need to renew my license, I’ll have another series of the same.

Today’s topic is a great one, from a human perspective, from a bodywork perspective—pain! 

Pain is such a complicated and fascinating facet of existence. The word ‘pain’ is derived from Greek and means punishment or penalty. The continuing ed class I took was slightly dated–from 2013 I believe–so it goes without saying that the statistics from the class have since been updated. Yet, I assure you, the sentiment is going to be the same.

Here are the stats compiled for that 2013 class:

• Pain is the number one reason why people go see doctors, and also the most common reason for seeking out alternative and complementary treatments.
• In 2011, the Institute of Medicine reported that 100 million Americans reported chronic pain and that the price tag associated with said pain, annually, was $635,000,000. You know that price has just gone up.
• 100 billion aspirin tablets are used annually in the world.
• The shape and color of pain tablets significantly change the effectiveness of the drug.
• Here’s a fun one to ponder: people over 60 tend to have less pain than those under 60.
• Talk therapy and back therapy both help with back pain…statistically about the same.
• Pain was considered a spiritual punishment prior to the 1600s. Only then did Rene Descartes attribute pain to tissue damage.

This model of tissue damage being the only source of pain creates a wall when chronic pain is compared to acute pain. With acute pain, you can usually point fingers to the source of the issue. When you remove the issue, pain theoretically goes away. 

Chronic pain usually doesn’t have a straight line connecting multiple dots. It typically has many lines creating a crazy pattern, thus making this type of pain unpredictable. Even if you remove all that seems to be causing the pain, the pain may not resolve. (This also makes me think of how you can cure something but not heal it, and vice versa.)

These facts lead to a rather large and looming factor about pain: Pain is an illusion. (But so is reality, right???)

I’m not sure about you, but this one sits sort of -eh- with me. But… as stated in the course packet for the class I took, “Tissue damage is not necessary or sufficient for pain.” 

From a personal bodywork perspective, I cannot tell you how many times–almost on a weekly basis–people will present with the same feel of the tissue. It could be a tightness, a knot, a collection of aggravated muscles–but one client will be miserable and the other one will tell me s/he feels great.

You know how much I love the brain. A client and I were just talking about the pain impulse coming only from the brain and not from the tissue or affected area at all. What then? (Ok, we know this can’t be the only way, just like the other way isn’t conclusive, either.)

There’s a study from 2004 (Derbyshire) that states “Brainwave patterns in people who think they are receiving painful stimulus but aren’t are almost identical to brainwaves of people actually receiving painful stimulus”.

The plot thickens…

We’ve all heard about phantom limb pain… again… our friend, the brain.

Under this umbrella, it kind of does look like the brain is causing the pains and not the other way around! It’s receiving the sensory input from the affected area, but depending on context, the person receiving it, memory, cellular memory… only then does the brain decide whether or not the sensory input painful.

Here’s the thing. And I’m not going to go into the particular population that likes pain–that’s another topic–but for the most part, we don’t like pain. We stray away from it. We do things to keep ourselves from being in pain.

Pain often alerts us when something is WRONG and needs attention. It keeps us from making more damage by asking us to change our behavior (like touching something hot). It can activate healing by encouraging us to get care (massages, chiropractic, etc). 

But. Pain can stop being of use when it’s no longer necessary for those responses.

According to this class, it’s believed that that brain processes pain like an emotion. Whether or not something reads as good or bad is an emotional assessment. Apparently brain studies have suggested that the midbrain is affected when something is painful, much like an emotion affects the midbrain. Pain can also be activated by the upper brain–for instance, if anxiety is an issue, pain can be perceived as worse.

The point of the class, I think, is that by observation or learning about pain, pain can be changed. There are studies suggesting that those who are invested in studying pain have less of it. If you can understand where it is coming from, it can lose its hold on you (whether or not you still feel it).

Of course, there’s the issue of chronic pain leading to brain conditions like depression, hypochondria, aforementioned anxiety, lack of sleep, cognitive impairment among others… which of course… can make pain worse.

It’s a slippery slope. I think the best way to deal with pain from a bodyworker’s perspective is honestly just to be attentive to the needs of the client. Offer validation by listening to the client and then palpating the affected area. Hopefully the combination of hearing the client as well as actively working the tissue is enough to offer even a tiny part of relief as part of a whole care regimen.

Thoughts about your own pain?

In Closing

Interestingly enough, when I typed in pain to find an image suitable for this post, the first images were all of emotional pain! And because of this emotional pain, these people were tightened into balls…which restricts movement..which can cause physical pain!

I’ve also purchased additional textbooks on the matter, so don’t be surprised if I talk about this fascinating topic again.

Thanks for reading!