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August 24, 2001
Article # 2 (Read about the series) - Download PDF

PAIN: It's all in your head!

By Anne Moscony, MA, OTR/L, CHT

What exactly is pain?
Pain is our body's normal protective response to any stimulus that causes potential or actual tissue damage. If you could never feel pain, you would continually injure your body!

Pain has a sensory component, an emotional component and a cognitive component. First our body must feel or 'sense' the pain. This message is then sent by our nerves to the brain for interpretation. If the brain does not receive the message, the body is not aware of the potentially harmful stimulus, and cannot respond to the pain.

Anesthesia blocks our awareness of pain. Doctors use drugs so we don't perceive pain during surgery. Still, cutting tissue during an operation qualifies as 'causing tissue damage'. Without this message reaching the brain, we are happily unaware of the pain. We can therefore say that pain is really 'all in your head!'

Once the message reaches the brain, several things happen. The brain registers the type and location of the pain. It compares this pain to previous experiences. It makes an executive decision about what to do about the pain, and organizes the body's response to the pain. If you are tired or scared, your tolerance for pain will change. The brain also controls your emotional state.

What exactly is pain?
Remember that acute pain is your body's healthy and normal response to a stimulus that can cause tissue damage. If you work through this pain, you risk further - and possibly permanent - tissue damage. Sometimes people are asked by health professionals to work through a certain amount of pain to achieve a specific rehab goal. However, only a licensed health care specialist with knowledge of anatomy, kinesiology, neuroanatomy and pathological conditions should make this determination.

How should I manage my pain?
Pain that results from an acute injury, that is, an injury that is less than 48 hours old, should be managed using the RICE approach: rest, ice, compression and elevation.

REST: rest the swollen painful body part. You should try to minimize any stress or load on the injured, painful part. You might need a temporary splint that would appropriately immobilize the injury. An athletic trainer and/or a physical or occupational therapist can recommend the right splint.

ICE: application of ice to a painful, acute injury will decrease the body's immediate inflammatory response. Stay tuned to this web site for more info on ice.

COMPRESSION: wrap the swollen, painful part with a circumferential bandage to minimize further swelling and pain. Ace wraps, athletic tape, and/or COBAN (a commercially available compression wrap) can all be used to provide light support around a swollen body part. A circumferential dressing or bandage such as this will temporarily minimize excessive swelling following an injury. Be sure to have a professional health care specialist explain the correct wrapping procedure, so you don't cut off circulation, and cause further damage.

ELEVATION: Elevate the injured body part. Swelling consists mostly of water -and water will flow in the direction of gravity's pull. If you can help the swelling to move toward the center of the body, your organs and your lymphatic system will help to dissipate this extra fluid. Therefore, use pillows to position the injured part at or above the level of your heart -particularly when you are resting.

Additionally, an over-the-counter medication, such as aspirin or ibuprofen, can be helpful in minimizing pain and swelling following an injury. Acetaminophen is helpful in managing pain, though it is not an anti-inflammatory. ALWAYS check with your physician before taking any medication, either prescription or over the counter. Remember do not train through pain! Managing your pain appropriately is the first step in getting better sooner than later.

 

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For more information, or with questions, please email: PaulR@PainRelief-PT.com