What is Pain?
Pain to us clinicians are interpreted a little differently compared to pain that patients experience.
Almost every therapist comes into contact with patients or clients who are in pain. Whether they
work in an inpatient or acute care setting or an outpatient specialty clinic, they are bound to meet
people that are in some sort of pain or discomfort. These patients might have sought out various
treatments, checked many doctors, seen multiple clinicians from different specialties, and still be in
pain. Their capacity to carry out their daily tasks can be constrained.
Patients frequently don’t fully comprehend why they are hurting or where it is coming from. They
simply know that trying to perform their daily chores or hobbies hurts. In fact, one of the most
crucial inquiries patients and clients have when they enter clinics is “why are you in pain?” The
challenge is to inform these patients about the origins of the pain they are feeling in a way that
would enable them to overcome it rather than paralyze them with worry or fear.
Explaining Pain
Sitting the patient down and explaining to them about “what is going on” can help calm them down.
Showing anatomical charts and pointing out a 3D model and addressing their situation is the most
efficient way to explain to patients. We have to cover tissue injuries, recovery times, and the healing
process to the patients thoroughly.
Beyond this Explanation
At some level, patients and clients may find this kind of education helpful, particularly if they have
already seen several professionals but still do not have a strong understanding of their diagnosis or
pain. Nevertheless, a significant portion of what is happening with a patient in pain is not covered by
this approach. It leaves out the brain, the neuroscience, and the essentials of pain itself. Many
patients and clients are utterly ignorant of the hidden forces that are probably at play when the
tissues and their dysfunction or injuries are described in detail, especially in the case of chronic
pain. Patients and clients may develop “catastrophizing” cognitive habits as a result of it.
Catastrophization, according to John Grohol, Ph.D., is “an irrational thought a lot of us
have in believing that something is far worse than it actually is. Catastrophizing can
generally can take two different forms: making a catastrophe out of a current situation,
and imagining making a catastrophe out of a future situation.”
There is growing evidence that using this biomechanical frame of reference when approaching
patient education might make patients and clients feel more scared, anxious, and stressed. It may
also have a detrimental impact on treatment outcomes clinically.
A New Explanation to Pain
Recent research findings suggest that there is a more successful method for communicating pain to
patients and clients. It is being referred to as Neuroscience Education (NE). To quote an article by
Louw et al., “[Neuroscience Education] can be best described as an educational session or sessions
describing the neurobiology and neurophysiology of pain, and pain processing by the nervous
system. Instead of a traditional model of connecting tissue injury or nociception and pain, NE aims
to describe how the nervous system, through peripheral nerve sensitization, central sensitization,
synaptic activity, and brain processing, interprets information from the tissues and that neural
activation, as either upregulation or downregulation, has the ability to modulate the pain
experience.”
Reframing the patient’s or client’s perspective on pain is the aim of NE. A patient or client may be
more inclined to move, exercise, and push themselves during therapy if they abandon the notion
that pain is an accurate indication of the damage to their tissues and redefine it instead as only the
brain’s perception of that threat.
Clinicians have the capability to change how patients perceive their symptoms, their causes, and
their implications. Also, they have a say in how their patients perceive their prognosis and possible
outcomes.
The Clinician’s Words Make a Huge Difference
Whether we like to acknowledge it or not, the words and tone we use while speaking to patients can
have a lasting effect. Our words have the potential to either encourage someone to overcome
dysfunction or chronic pain, or they have the potential to freeze them into a destructive thought
pattern that might harm their prognosis or outcomes.
There’s a good chance that many of the patients and clients who visit clinics have heard phrases like
“slipped disc,” “damaged tissue,” “relax till it gets better,” or even “you’re not going to get well.”
Whether they were correct or incorrect, the clinicians who spoke to them left a lasting impression
that may still have an impact on that person when they enter clinics for the first time.
Clinicians should first spend time explaining to these patients the neuroscience underlying their
pain in an effort to change their perspective on their diagnosis and future prognosis. Empowering
these individuals to deal with their pain and dysfunction should be the main objective.
How is Pain Interpreted
Our brain processes pain information and forms different areas in our brain that make a pain map.
These areas are:
- The sensation area
- The movement area
- Focus and concentration area
- Fear area
- Memory area
- Motivation area
- Stress response area
Every instance of pain may involve one or more of these locations. They communicate with one
another to “discuss” the proper course of action or response. Each of these reactions and locations
may be impacted differently depending on the individual. An ankle sprain can cause pain in
completely different ways for different people. Because everyone experiences pain differently, it can
be challenging to treat.
It has been demonstrated that this method of educating patients and customers on some doable
activities to assist move the recovery needle reduces hospital stays, improves functional results, and
even lowers health care expenses for those individuals.
Bottom Line
These are some of the science and the reason why we stand behind our value of “Don’t treat the
pain, treat the brain”. Lead Rehabs emphasizes in treating the core regions of any discomfort that a
patient might experience, and we believe that attending to the root issue and explaining the
interpretation of pain to our patients solves a majority if their worries.
