Pain Management

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.

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.

Acute pain: short-term pains act as an alarm, telling us that something is wrong. While most minor pains are easily treated and quickly forgotten, others are a sign of something more serious that we shouldn’t ignore. For example, the pain of a broken leg is helpful because it makes us rest the leg until it heals.

Chronic pain is usually defined as pain that persists beyond the normal time that tissues take to heal following an injury. Most soft tissue injuries heal up within weeks, although some can take several months to completely heal. If a pain continues longer than 3-6 months, it is usually described by pain specialists as “chronic” or persistent pain. The causes of chronic pain are not always clear but in some conditions the pain is thought to be due to the pain signals through the nerve fibers becoming confused. The brain is then unable to understand the signals properly