Why do I hurt?
One question I find myself answering from every patient is: Why do I have pain? We all want to know the cause and the cure. So we seek professional help from doctors, family and friends. We are offered medicine, ointments and advice. Do this, don’t do that. Some of it helps, much of it won’t.
We can patch up wounds, mend broken bones and repair tendons. But sometimes, long after the injury resolved, we are left with pain. Sometimes the pain is made worse with activity, or maybe its only there in the morning. Most often rest and “feel good” stuff like heat and ice is good enough to take care of daily mishaps. Still others may have such dysfunction that they seek surgery.
In the United States alone there are 800,000+ knee replacements a year, and that number is growing every year! Advanced knee arthritis is a primary cause. A study from Harvard determined that arthritis is a largely preventable disease. People born before WWII were half as likely to have developed arthritis in their lifetime. Something changed, and we’re still combing through the details of why that’s happening.
So why do we still have pain after surgery or after an injury has healed? What exactly is pain?
Pain is an experience. Think of the smell, taste, texture of your favorite meal. I bet you can even imagine eating that meal in your favorite chair surrounded by your best friends. That’s kind of how pain is. It’s not only a physical sensation of discomfort. It is also a memory. If you were to revisit the place where you had a serious injury, you may be able to recall who else was in the room, what you were wearing, and how you took care of the injury at that moment.
Pain is all of those things. It can be caused by a physical sensation like heat or cold. It can also be triggered by a memory. Recollection obviously does not recreate the physical trauma, but you may still experience pain.
Scientists have been measuring certain components of nociception for decades. Nociception is sending a pain signal to the brain. These signals travel along nerves. Some nerves can sense pressure, others can sense heat or cold. Nociception acts as an alarm bell, drawing attention to the body part.
Sometimes the alarm system becomes dysfunctional. If you were to step on a thumbtack, you would immediately retract the foot. This is a reflex. It is an automatic process. First, the pin pierced the skin, and a signal was sent to the spinal cord and brain. The body automatically responded by removing the foot from the pin, and a signal also went to the brain to say “PAIN”. This is a normally functioning response.
However, in a dysfunctional system, that signal from the pin piercing the skin would be sent without the pin ever physically piercing the skin. Kind of “All bark, no bite”. That signal is relentless, screaming “Pay attention, pay attention!” But there’s no pin in the foot. There is no structural damage going on.
Research has uncovered part of why this happens. Some causes may be attributed to physical nerve damage, altered chemical metabolism, changes in nerve signaling, our perceptions and even cultural perspectives.
Whatever the “cause” is, treatment interventions have been extensively studied for generations. Our understanding has come a long way, and much work needs to be done. Dysfunctional “signals” can be more of just a small bother. Very often chronic pain conditions can significantly affect our quality of life.
Pain can shrink our worlds, pulling us away from friends and family because we developed a long held belief that movement causes pain, and you don’t want to experience pain. So over the months and years, people categorically eliminate social functions or hobbies, or even careers to avoid pain.
As a physical therapist in Miami, Florida I have been helping athletes of all types learn about their injuries, guiding them through throughout the entire process. From the clinic straight to competition, I have assisted thousands of professional athletes- dancers, fighters, weightlifters and even Olympians! I help them better understand why they’re in pain, then develop a plan to get back to training and competing. Whatever their goals are, we get them done.
So if you are an active person looking to stay fit for life and there’s a pain that you just can’t get rid of, give me a call and let me help you solve it.