What is pain?
Pain is an unpleasant sensation or emotion associated with actual or potential tissue damage. Everyone experiences it, and while unpleasant, pain serves as a critical protective alarm system.
Acute Pain
Acute pain is temporary — the kind experienced with broken bones, muscle injuries, sore throats, or burns. It prompts protective action during healing. However, sometimes the alarm becomes oversensitive, persisting long after healing or despite minimal injury. This is chronic or persistent pain, which lacks protective value and complicates daily living.
Key Points About Pain
Pain affects one in five New Zealanders. It is:
- Personal: Individual experiences vary significantly
- Complex: Involves multiple body systems including emotions, stress, sleep patterns, beliefs, and immunity. This complexity requires time to understand and develop appropriate management strategies.
The 'Alarm System' Analogy
The nervous system functions like a house alarm. Just as faulty alarms trigger from wind or burnt toast rather than genuine danger, pain receptors can become hypersensitive. Normal stimuli — stepping on a rounded stone, clothing contact, or even movement thoughts — can trigger pain responses equivalent to stepping on a nail.
Sensitisation
"Sensitisation" describes when protective alarm systems become overactive. Clothing, daily tasks, or movement thoughts trigger sensitive systems. Persistent pain can isolate people from hobbies, family, and friends, potentially causing sadness, frustration, and anxiety.
How Physiotherapists Help
Physiotherapists understand pain mechanisms and the nervous system. They assist in resetting sensitive nervous systems while empowering patients to improve. Complete pain elimination isn't always possible, but living well with pain is achievable.
Assessment involves exploring emotions, thoughts, beliefs about pain, and sleep quality — recognising these as crucial components.
Treatments
Movement and Exercise
While protective avoidance helps short-term, habitual movement avoidance can worsen pain. Fear of movement triggers alarm systems, and even thinking about problematic movements can activate pain responses. Physiotherapists help pace and set realistic, small goals. Finding enjoyable movement forms is essential.
Education
Emerging research provides tools and resources for understanding pain and safely desensitising overactive alarm systems.