***Pain is cruel. It can take many forms. It is real no matter the source or the cause. And it can last forever.***
Those of us who suffer from severe, chronic pain know how it can disrupt and damage our lives making it impossible to enjoy even the simplest of daily activities. And, even worse, those whose pain can not be demonstrated by some quantifiable medical test are labeled as psychologically damaged – the pain is psychosomatic or using a newer medical term, the pain is “functional”. These labels only mean that medical testing, no matter the sophistication, can not determine the cause of the pain. In other words, the doctors don’t know what’s wrong. It does not mean that pain is not real. All pain is real.
***A person’s experience with pain and how they feel pain is unique to the individual, and it can not be measured from the outside.***
All pain is regulated by the brain. When we smash our finger with a hammer, we have pain in which the source of the pain is obvious. But sometimes it’s an injury that we can not see and do not remember. Maybe it’s something that should have healed. Maybe it’s an infection or inflammation that escapes detection. Maybe it’s our own body trying to fight some unknown enemy and only fights itself instead. In all cases, it is nerve fibers that are sending messages to our brains causing us to feel pain.
Pain works the same way wherever it exists in our bodies:
(1) There is the source of the pain. In the picture above, the source of the pain is in the person’s left arm. But the pain could be anywhere or, as some of us may experience, the pain may be in multiple spots at the same time. It may seem to be everywhere at once.
(2) Pain is transmitted through peripheral nerves and up the spinal cord. Therefore, damage to the peripheral nerves or damage to the spinal cord will disrupt this transmission in some way. So, if we have damage to the peripheral nerves (such as some kind of peripheral neuropathy), the signals may be lessened or they may be heightened which might explain why the same pain is different from one person to the next. In the same manner, damage to the spinal cord may also disrupt pain signals. So, that back injury or the damage to our spinal cord caused by arthritis or other degenerative disease may impact the pain we feel not only in our back but in our entire body.
(3) When these pain messages reach the brain, the brain interprets them as being “pain” and interprets what type of pain is suffered – burning, stinging, aching, throbbing, etc. The brain also interprets the severity of the pain. Again, this helps explain why pain may be different between individuals and why pain is unique to each person.
(4) The brain sends out “pain suppressing chemicals” to the pain source and triggers other responses to the pain such as causing us to cry out, or causing our heart rate to increase or causing us to break out in a sweat, etc.
When pain is chronic, we suffer an unrelenting pain signal that travels up the spine to the brain. Eventually, the transmission circuits for this pain become more efficient at transmitting these signals making the pain feel worse and more intense. Over time, the threshold for pain is lowered, and a less intense stimulus for pain may cause a nerve to discharge and send its signal to the spine and on to the brain. Or the nerves may become damaged from disease and send more and more pain signals to the brain.
Obviously, pain is very real. But pain is also tied to our emotions.
***Emotions, just like pain, are created by the brain by way of a complex interaction of electrical and chemical impulses in the brain, resulting in a cascade of nerves firing and chemicals being secreted.***
The part of the brain where we form and register emotions is the limbic system which is a set of midbrain structures that surround the thalamus. The limbic system is also the pain-processing center that is responsible for filtering and prioritizing all the impulses the brain receives.
Pain signals are, in one way, our bodies trying to protect us from the source of the pain. When we feel pain, we also feel a set of adverse emotions that cause us to try to move away from whatever is causing the pain. Having pain is a strong emotional experience. It reshapes behavior and how we interact with our world.
Because pain and our emotions are so connected, chronic pain often leads to psychological disorders:
(1) There is a high prevalence of psychological comorbidities among patients with chronic pain. Again, this does not mean that pain is “all in our heads”. It does mean that unrelenting pain impacts upon our emotions and our psychological well-being.
(2) Having chronic pain may cause emotional distress and make already existing psychological problems even worse. What this means is that people who were able to effectively control their emotions without pain find that the pain triggers adverse emotional responses such as anger and irritability. So, those prone to easily getting angry or becoming depressed will be more susceptible to these problems because they suffer from chronic pain.
(3) Emotional problems may cause pain to become more intense making our disability worse and therefore perpetuate our dysfunction. So, it’s important to recognize our emotional problems and vulnerabilities and treat them along with our pain. Otherwise we may find ourselves in a never ending downward spiral from which we can not recover. Unrecognized and untreated emotional and psychological distress may interfere with the successful treatment of our chronic pain.
***The link between pain and emotions is one reason why I think that emphasizing positive emotions can help us deal with our pain. When we are happy, we might hurt less. I believe that when we find ways to fill our brains with joy, it is a distraction to pain and helps us manage what is otherwise intolerable.***
What else can we do about it?
- Manage pain by releasing your inner endorphins. Pain and emotions are intertwined. If we can find ways to help our brain send out some of those helpful chemicals rather tan trigger adverse emotions, we are better off. I share some of my ideas in the following previous blog: https://mcreyscope.com/2014/04/28/manage-pain-by-releasing-your-inner-endorphins/
- Eat a healthy diet. It doesn’t do ourselves any good to keep poisoning our bodies with so much processed food and sugars. Eat raw fruits and veggies. Eat organic foods when you can. Some foods can even help with pain. I wrote about 10 foods that can fight pain in the following blog: https://mcreyscope.com/2014/02/12/top-ten-foods-to-fight-pain/
- Be active and exercise if you can. Many doctors prescribe physical therapy routinely. Most people think if we would just exercise more, then we wouldn’t hurt so much. I think we have to try to be as active as we possibly can be but we have to be realistic about what we do. If we do too much, then all we do is make our problems worse. I have written a blog about dealing with some of these issues: https://mcreyscope.com/2014/03/03/tips-on-how-to-survive-physical-rehabilitation-with-a-chronic-debilitating-disease/
- Learn to deal with uncertainty. In many cases, doctors can not tell you exactly why you feel so much pain. You might find yourself in a fog about how to fight your pain. I have shared some techniques about dealing with uncertainty in the following previous blog: https://mcreyscope.com/2014/05/22/dealing-with-uncertainty-in-chronic-illness/
- Use your faith to guide you. Nothing helps me more than my faith in God. Maybe you don’t believe in God or any higher power. Then this suggestion is not for you. But for those who believe, faith is a powerful medicine. See my previous blog at: https://mcreyscope.com/2014/02/09/fighting-your-illness-with-peace-and-joy/
- Use medications wisely. Medication is an important therapy for chronic pain. But sometimes it can be our worst enemy. Learning to cope with chronic pain with the least amount of medicine is one strategy that I think can be effective for a lot of people. Learning how to cope with chronic pain with or without medication is important. I wrote about my experiences in an earlier blog (which has been passed out to patients of at least two pain clinics): https://mcreyscope.com/2014/02/01/how-to-try-to-cope-with-chronic-pain/
- Have a support system in place. When our pain in unmanageable, we need someone to talk to, to be with us, to support us in our time of need. We really need this support system to be in place 24 hours a day, 7 days per week. Sometimes, this is our spouse or significant other. Sometimes, it’s our best friend. Sometimes, it might be a neighbor. It’s more than just a caregiver. It’s that rock that we can hold onto. If you don’t have this person or persons in your life, reach out to your community. Don’t be alone. When you are alone, those bad emotions take hold and you lose the effectiveness of all those positive emotions that can help you so much. So go to church or go to a community center. Look for it in people you interact with everyday – at work, in a store or even in a restaurant you frequent often. If you ask, you just might find that there are many people willing to help you. But if you stay silent, you will always be alone with your pain.
- Be a chronic pain warrior! Living with chronic pain is a constant battle. Never, ever give up!
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