Chronic Pain

Have You Considered That Pain Is Necessary?

You have heard it said, “No pain…no gain.”  But, do we really believe that?  The concept of pain is generally believed to be something to be avoided.  I have never met anyone who liked pain.

And yet, do you know that you would be worse off without it?  There are a number of disorders that are characterized by a lack of the ability to feel pain.  Those people suffer many serious complications because of the lack of pain.

Now I am not going to try to convince you that chronic pain is “good”.  Chronic pain is any pain that is continuous daily and continues for 3 or more months.  In the case of chronic pain it becomes its own disease.  It causes physiologic changes that are independent of the disease process causing the pain.

pain overview

My point is that acute pain is a process that is very detrimental to health when it does not exist.  This may be a new concept for you.  Let me explain some basics about pain first.

Pain Is Philosophical

The definition of pain is fairly vague, “physical suffering or discomfort caused by illness or injury.” Notice that this definition does not include emotional pain.  However, it does infer that to have pain there must be a cause.

The definition actually effects the way people see pain.  Have you ever had pain that could not be diagnosed?  What was the reaction of those around you?  What about the reaction of your Doctor?

Perhaps your own perception of what you were feeling was distorted.  Were you still having pain even though the cause could not be diagnosed?

Pain is like so many other strong experiences in life…it is very individual.  And yet, the treatment of it is greatly affected by the perceptions of those around us.  Pain that cannot be verified calls into question its existence.  The mere reporting of pain by a person may not be enough to convince the “pain judges” around a person to take it seriously.

So having pain gets philosophical.  Do you believe a person who says they are in pain?  What if you can’t demonstrate a physical finding or diagnostic study that supports its existence?  Will you still believe?

Pain Is Physiologically

Pain is divided into 3 basic types:

1)  Somatic:  that is pain that comes from a visible illness or injury.  The acute pain response is adaptive in that it causes the individual to do something to decrease the pain.  It evokes self-preservation.

2)  Visceral:  this is pain that occurs from internal illness or injury.  It may be less obvious but is no less a threat to the individual (sometimes more a threat).  A specific organ or organ system is dysfunctional.

3)  Neuropathic:  this is pain that may be visible or invisible.  It may be the result of a specific organ or organ system dysfunction.  It may also come from dysfunction of the system that generates the perception of pain…the nervous system.

pain classification

Of the 3 types of pain, neuropathic pain gives clinicians the hardest time to diagnose and treat.  Neuropathic pain management can get philosophical…

Acute pain functions similar to a house alarm system.  It alerts the individual that there has been an intrusion of illness or injury.  The sensation of pain triggers a series of responses from other systems.

The other systems are designed to identify, repair, and combat the source of dysfunction.  Without the acute pain there would be no alarm and, therefore, a delayed response.  Just as would happen if a house alarm system malfunctioned.

What happens if the “early warning system” of acute pain malfunctions?  Let me explain…

Why Must We Have It

There are 3 classic illnesses that are characterized by a lack of pain:

1)  Congenital Insensitivity to Pain Syndrome (CIPS):  in this syndrome (quite rare) a human being is born not being able to perceive pain. The other special senses are usually intact.

It occurs as a gene mutation.  As the person grows, the insensitivity leads to repeated injuries that cannot be felt by the individual.  The accumulated trauma, or the occurrence of illness that would usually result in a pain alert but doesn’t, results in an early death.

2)  Leprosy:  this is an infectious disease that is prevalent in under-developed areas of the world.  The disease invades nerves and other areas of the body causing disfigurement.

It results in anesthesia of the areas where the bacteria grows.  Trauma to these areas may be undetected and complications arise from the lack of an acute pain alert.

Leprosy is a treatable infection and has been a major focus of the World Health Organization for eradication.  This has not been achieved as yet.

3)  Diabetic Neuropathy:  Diabetes Mellitus has a toxic effect on nerves.  The result of poorly controlled blood sugars can result in anesthesia and/or pain of the toes, feet, fingers, and elsewhere.

Here again, the lack of pain allows trauma to go undetected and complications develop.  Foot ulcers occur largely from undetected injury to the skin as the feet become anesthetized from Diabetes.

Diabetic Neuropathy

In all 3 diseases the primary complication of the lack of pain is early death.  Acute pain gives humanity a survival advantage. 

Final Comments On Acute Pain

Acute pain is necessary for good health.  Pain is like an alarm system that alerts us that something is wrong.

The perception of pain by the person in pain, and other observers, is very individualized.  At times, the interpretation of the perception of pain becomes philosophical.

Because pain is experienced by every human being at one time or another, people have learned concepts about pain.  This learning effects how they interpret pain in themselves and others.  In that acute pain is adaptive, chronic pain can be confusing.  Chronic pain is maladaptive and serves no meaningful survival advantage.

This confusion has led to inconsistencies about the diagnosis and treatment of chronic pain.  Chronic pain utilizes different neurologic mechanisms, has different processing pathways, and results in different consequences for human beings.  This entire website is dedicated to teaching you those differences.

I hope this post about pain has helped you to understand its’ nuance.  I have enjoyed presenting this to you.

Please comment.I would love to hear from you.

Wishing you joy and healing,

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