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We will all deal with pain at some point in our lives. Unfortunately, some of us will experience it more than others. And some will even endure chronic pain — pain lasting for more than 3 months.  A recent study showed that in 2016, “approximately 20 percent of U.S. adults had chronic pain and 8 percent had high-impact chronic pain—meaning pain that limited at least one major life activity“.

Living with chronic pain can lead to a feeling of helplessness and defeat. But studies show that merely understanding how pain works can help provide relief and empower patients. So in a sense, pain education can be a form of treatment.

Pain science is continually growing field that spans many disciplines can become quite complex, but fortunately more resources are being developed all the time that can help translate much of the complicated “science-speak” into useful, actionable concepts for the rest of us. A recent video written by Joshua W. Pate and  produced by TEDEd does an excellent job of communicating some important pain concepts in to just 5 entertaining minutes. (Check out the entire video below.)

Don’t have 5 minutes to spare or prefer reading to edutainment? Scroll down for the “spoilers” or read the entire transcript below.

 

For those few boring souls who don’t like educational cartoons 😉 , here are a few of the important takeaways:

  1. Pain does NOT equal tissue damage – It’s a natural response to assume there is some physiological problem when we experience pain. But this isn’t always the case. In fact, this additional stress can actually increase the pain.
  2. Chronic pain can become “learned” if not treated early – That’s right. Our brains can actually learn how to produce pain more effectively if the pain is not addressed early.
  3. Mental and emotional support is important for pain relief – Living with chronic pain can be extremely isolating and depressing. Having a mental and emotional support team can help build resilience.
  4. A multidisciplinary approach to treating chronic pain may achieve the best results – Because chronic pain is often multifaceted, the treatment protocol should be too. This could include treatments like massage therapy, physical therapy, psychotherapy, and others.

 


Transcript: “In 1995, the British Medical Journal published an astonishing report about a 29-year-old builder. He accidentally jumped onto a 15-centimeter nail, which pierced straight through his steel-toed boot. He was in such agonizing pain that even the smallest movement was unbearable.

But when the doctors took off his boot, they faced a surprising sight: the nail had never touched his foot at all. For hundreds of years, scientists thought that pain was a direct response to damage. By that logic, the more severe an injury is, the more pain it should cause. But as we’ve learned more about the science of pain, we’ve discovered that pain and tissue damage don’t always go hand in hand, even when the body’s threat signaling mechanisms are fully functioning.

We’re capable of experiencing severe pain out of proportion to an actual injury, and even pain without any injury, like the builder, or the well-documented cases of male partners of pregnant women experiencing pain during the pregnancy or labor. What’s going on here? There are actually two phenomena at play: the experience of pain, and a biological process called nociception. Nociception is part of the nervous system’s protective response to harmful or potentially harmful stimuli. Sensors in specialized nerve endings detect mechanical, thermal, and chemical threats.

If enough sensors are activated, electrical signals shoot up the nerve to the spine and on to the brain. The brain weighs the importance of these signals and produces pain if it decides the body needs protection.

Typically, pain helps the body avoid further injury or damage. But there are a whole set of factors besides nociception that can influence the experience of pain— and make pain less useful. First, there are biological factors that amplify nociceptive signals to the brain. If nerve fibers are activated repeatedly, the brain may decide they need to be more sensitive to adequately protect the body from threats. More stress sensors can be added to nerve fibers until they become so sensitive that even light touches to the skin spark intense electrical signals.

In other cases, nerves adapt to send signals more efficiently, amplifying the message. These forms of amplification are most common in people experiencing chronic pain, which is defined as pain lasting more than 3 months. When the nervous system is nudged into an ongoing state of high alert, pain can outlast physical injury. This creates a vicious cycle in which the longer pain persists, the more difficult it becomes to reverse. Psychological factors clearly play a role in pain too, potentially by influencing nociception and by influencing the brain directly.

A person’s emotional state, memories, beliefs about pain and expectations about treatment can all influence how much pain they experience. In one study, children who reported believing they had no control over pain actually experienced more intense pain than those who believed they had some control.

Features of the environment matter too; In one experiment, volunteers with a cold rod placed on the back of their hand reported feeling more pain when they were shown a red light than a blue one, even though the rod was the same temperature each time.

Finally, social factors like the availability of family support can affect perception of pain. All of this means that a multi-pronged approach to pain treatment that includes pain specialists, physical therapists, clinical psychologists, nurses and other healthcare professionals is often most effective. We’re only beginning to uncover the mechanisms behind the experience of pain, but there are some promising areas of research.

Until recently, we thought the glial cells surrounding neurons were just support structures, but now we know they have a huge role in influencing nociception. Studies have shown that disabling certain brain circuits in the amygdala can eliminate pain in rats. And genetic testing in people with rare disorders that prevent them from feeling pain have pinpointed several other possible targets for drugs and perhaps eventually gene therapy.”