Part 2

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PAIN

Pain is a SYMPTOM

DISABILITY is a restriction of function

Pain and disability often go together but are not always the same.

The amount of disability is not always proportional to the severity of the pain.

“Pain can be defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” (International Association for the Study of Pain)

REMEMBER! - Pain is whatever you say it is, existing whenever you say it does!

CHRONIC PAIN

On going pain may be likened to an annoying tune playing all the time in your head!

The tune is in your brain telling you that you have pain, rather than the tissues that are injured.

This does not mean that it is all in your head but that the origins are very complex.

LEARN TO TURN THE VOLUME DOWN!

ACUTE PAIN

Pain receptors are present in most human tissue

There are 3 main types of nerve fibres

A Beta – non-painful stimuli

A Delta – painful fast

C – painful slow

Involves fast acting nerve fibres

Less than 3 months duration

Pain intensity increases as stimulus increases

Pain stops when stimulus stops

Severe, sudden, limiting and protecting

A symptom in response to an injury

Protects from further injury and allows healing to occur

Responds well to medication and pain relieving treatments

Primarily affects the individual

Involves the slow acting nerve fibres

More than 3 months in duration

Previous painful condition causes a hypersensitive state

Mild, normally painless stimuli cause pain

Painful stimuli cause excessive, prolonged pain

Pain is not due to pathology, but to de-conditioned tissues and different cell responses

Pain pathways remain open, cells become overactive and hypersensitive

Pain becomes a condition in its own right

Ill defined time of onset

Responds less well to medication and pain relieving treatments

Associated with emotional and psychological changes

Involves the individual but also the family, social network, friends and lifestyle

THE PAIN GATE THEORY

Imaginary gate to our consciousness

In chronic pain the gate remains open

The body can regulate the flow of pain

Stimuli can be suppressed

These stimuli can be suppressed from the outside or can descend from the brain

Pain can be modulated consciously by mental, emotional and sensory inputs

Pain can gain access over many things

It reduces concentration levels

Less severe pain can disappear when we focus on something else

HOW DO WE KEEP THE GATE OPEN?

Lack of movement, under activity

Focusing on the pain sensation

Stress

Anxiety

Over activity

Drug dependency (e.g..painkillers)

Negative thoughts

Memory of past experiences

HOW DO WE CLOSE THE GATE?

Distraction

Movement, exercise

Relaxation techniques

Heat / ice

Massage

Good posture

TENS

Medication

Positive thoughts

EXERCISE – PHYSICAL EFFECTS OF PAIN

Weight gain - Weight Lose

Muscle weakness

Decreased flexibility, general stiffness

Poor posture

Reduced circulation

Poor self image

Lack of confidence

WHY SHOULD WE EXERCISE?

Release of endorphins

Increased metabolism

Improved muscle strength

Improved flexibility

Improved self image

Increased energy levels

Decrease stress

Improved sleep

You will not cause further damage if you exercise in a sensible, controlled and paced way.

You will feel some stiffness when you first start to exercise!