The Language of Pain
Pain is an experience that humanity shares across centuries and cultures. It connects us, motivates us, scares us, drives us forward, stops us in our tracks, and is a source of emotional growth and wisdom. While pain is familiar to everybody, the experience and relationship one has to pain are highly individualized. Some people find it comforting while others detest it; for one person, pain may be a source of attention and for another person, it may be a source of shame. Pain is a global topic of conversation; if there is nothing else to say, you can always talk about your pain. The older we get, the more shades of pain we have likely experienced, and the more we might have to say about those experiences. But what are we really talking about when we discuss pain?
Pain is the language of the body
It is the only voice the body has available to communicate when something is wrong; similar to how crying is the only language that a baby has at hand. Thus we need to really listen when somebody is telling us about their pain, whether we are family, friends, or professionals to those individuals.
The body is a complex interconnected web, and a tug somewhere will show up as pain somewhere else. This means that where a person feels pain is often not where the problem is. For instance, a serious stomachache can be rooted in a misalignment of the jaw or a pulled muscle in the back, or earache can stem from tightness in neck muscles.
Mechanism of pain
In order to “cure” pain, we need to understand both the body and brain so that we have a platform from which to reason. Pain is in the brain, by which I mean that it is a subjective perception and interpretation of incoming nerve signals from the body to the spinal cord and brain. The pain in the body starts with special nerve endings called nociceptors, which are free nerve endings found in skin, muscle, bone, joints, viscera and fascia. The nociceptors are sensitive to mechanical injury, temperature, and inflammation. As soon as they are activated, the nerve signals are carried first to the spinal cord and then the brain. Two different types of nerve fibers convey the messages from the nociceptors to the spinal cord: one type is faster and transmits sharp acute pain and one is slower and conducts the dull ache.
As soon as the information reaches the spinal cord, much action takes place. If the pain stems from touching a hot stove or stepping on a nail, there is no time for thinking. A fast message goes straight back out from the spinal cord to the skeletal muscles with the command of getting away from the immediate danger, either move the hand or jump from the nail. In the meantime, the information goes up the spinal cord to the brain where it is interpreted and brought to consciousness. The latter enables you to feel the sharp, throbbing or dull pain, and perhaps have a physiological and/or emotional reaction such as shaking, vomiting, crying, raging, or laughing.
The texture and intensity of the pain as well as the emotion that accompanies it depends on your particular neurological makeup for pain perception. As the pain signal travels up the spinal cord it will be modulated at several levels through complex inter-neuronal processes. The brain’s final translation of the information takes into consideration what happened along the spinal cord as well as past experiences. The latter includes parental care, previous trauma, and cultural habits. For instance, if a child learns early in life that the smallest pain results in a big reward, it is very likely that the benefits associated with pain will stay with the child for the rest of her or his life. On the other hand, if a child in agony is humiliated and considered weak, he or she might learn to suppress discomfort, and as an adult take pride in having a high tolerance for pain. A child’s brain is extremely plastic (changeable) and therefore childhood experiences, good and bad, create deep tracks in the brain. As we grow older our brains are still plastic, but less so, and it takes a lot more effort and repetitions to create change.
Treating pain
Treatment of pain in western society is primarily done from the point of view that it is a nuisance and hindrance that needs to be eliminated. Thus much money is put into medicines that aim to mask and mute the pain. The mismanagement of the number one pain “killer,” Opioids was the cause of 47,600 deaths in 2017 in the US.
In order to change our treatment of pain and promote health versus sickness, we need to start seeing pain as a reminder instead of as a problem. Most people live fast-paced, stressful lives where there is often a lack of balance between work and free time, how much we eat versus what we need, and how much we move versus sit. An imbalanced lifestyle impacts the brain chemistry, which in turn influences the body & brain interaction. The result can be visceral, fascial, and musculoskeletal inequities and pain.
Alternative treatment of pain
As a new approach to pain treatment, we could begin with awareness rather than drugs. Attention to the body can bring to consciousness things we are doing (or not) and habits that could be either causing or feeding the pain. By becoming more conscious of the patterns that affect our bodies, we can make choices to change our behaviors and stop doing what is causing pain in the first place.
Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.Viktor E. Frankl
If, for instance, you spend most of your time sitting, try moving; or if you are always on your feet, have a seat from time to time. In a fitness scenario, do not cross the pain threshold; the “no pain, no gain” myth is old and outdated. First, explore what you can do without pain and then tweak it: if a deep squat hurts, try a mini squat. By performing pain-free movements the brain gets the message that you are safe, and thus some of the protective mechanisms (read pain) are removed. Our breathing pattern is a powerful tool to modulate pain. Shallow breathing feeds the pain while deeper abdominal breathing soothes it, thus we need to be mindful of our breathing throughout the day.
Awareness of how we feel along with breathing are key components to create a conscious link between the body and brain, and this connection is essential in order to treat pain and live well. Physiologically, the brain and body are one inseparable unit, and whatever happens in one place will affect the other. In practice, this means that “uppers” or “downers” for the brain will influence the muscles and the organs of the body, and painkillers for the body will impact the brain.
In Conclusion
I propose that in order to create a shift in pain treatment, society needs to approach pain with curiosity and listen to what it may be trying to say. We have to make an effort to honor our bodies, slow down, ponder, rest, and pause for a moment before we reach for the painkiller or call the doctor. I am not suggesting that we should put ourselves at any risk by avoiding medical treatment, just proposing that perhaps the pain in our bodies is a scream for attention, rest or movement, rather than for urgent medical care.
