What is pain and how do we deal with it? (Part one)

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described as such.

Several very important concepts are hidden in this definition:

• An unpleasant sensory and emotional experience. Unlike other sensations such as sight, hearing, smell, taste, and touch, pain is always linked to an unpleasant emotion. Think for a moment about the painful experiences you have gone through – has any of them been pleasant?
• Actual or potential tissue damage. When you think about the pains you have experienced, you remember that they are caused by tissue damages such as lacerations, strains, twists, burns, fractures, etc.

Why do I have pain?

We know that pain is a warning signal that something is not right in our body. It allows us to understand the damage, locate it, and mobilizes us for the stress response. It is like a loud siren telling us: beware! beware! something is wrong! get out of the situation and find what's wrong!

But sometimes the warning system triggers an unnecessary alarm or larger than needed. This “alarm siren“ continues to blare even when there is no damage or the disease has healed.

In some types of chronic pain, many examinations and laboratory tests find nothing abnormal to explain the pain; in these cases, the doctor often tells the patient “the pain is in your head“.

The fact that all laboratory tests are normal does not mean that it is psycho-genic. Psychiatric disorders and simulation are very rare in patients with chronic pain.

On the other hand, we need to know that chronic pain leads to psychological consequences such as depression, anxiety, or stress. One or several of these consequences are found in most patients with chronic pain, but that does not mean that the cause of the pain is psychogenic.

For a patient with chronic pain, one of the most important things a doctor can do is to say: I believe you are suffering from pain and will try to alleviate it, even without finding its cause.

How to deal with pain when we cannot find or treat its cause? There are many such examples, e.g.:

• Headaches and migraines. After excluding (with various analyses and examinations) something “terrible” inside the head, what remains is the treatment of the pain.
• Back pain with aging. Surgery is rarely advised and the only treatment is pain management.
• Arthritis pain. Joints wear out, deform, or tear and often cannot be healed. In these conditions, controlling the pain (and not repairing the joint) becomes the main goal of the treatment.

Where can I seek help?

If the pain is not relieved by over-the-counter analgesics from the pharmacy or continues longer than you thought, then go to your family doctor.

If the treatment given by him/her does not relieve you, then go to a pain clinic. In these clinics, you will find medical personnel who will believe you, understand you, and help you to calm the strong unresting pain.

What treatments can be offered to you?

There are a range of treatments to control pain. Some of them work in some patients, while in others they do not. This is explained by the fact that pain is an individual experience.

The doctor may try a number of treatments on you in the hope that they will be successful. This does not mean that he/she is “experimenting“. Sometimes treatments do not give results right from the start and it takes a few weeks to assess their effectiveness. In other cases, they work initially, but over time the effect decreases.