The International Association for the Study of Pain (IASP) defines pain as, ‘An unpleasant sensory and emotional experience associated with, actual or potential tissue damage.’ The concept of pain has evolved by identifying that biological, physiological and social factors affect each individual differently. Pain is very subjective, depending on the individual’s prior experiences.
Why do we feel pain?
The brain is constantly sensing what is happening in the body to detect any danger, threat of injury or actual injury. When the body senses danger or injury, the feeling of pain is created. Pain is the way the brain protects us from further injury or permanent damage.
You can still experience pain if there is no actual injury or tissue damage. Sometimes your brain may not create the feeling of pain even if there is tissue damage. In other circumstances, pain can continue even after an injury has healed.
What impact can pain have on our lives?
Pain can compromise our ability to complete our normal daily tasks as well as exercise. If the pain is ongoing or in a chronic state, it can also have a detrimental effect on an individual’s mood and quality of life. Chronic pain is the second most common reason for seeing a doctor and missing work.
What are the different types of pain?
Acute pain – can last from minutes to three months. It is physiological pain, therefore the pain subsides after the injury heals. Immobilisation promotes recovery.
Chronic pain – occurs when recovery has been delayed or incomplete. It is pain that has persisted longer than 3 months and can last from months to years. Chronic pain is pathological pain that can be mild or excruciating, constant or episodic, inconvenient or incapacitating.
Nociceptive pain – stimulation of nociceptors. This is a normal response to tissue damage and the pain diminishes as the tissue damage heals.
Neuropathic – sharp, shooting pain. It is due to damage to the nerves or other areas of the nervous system. The neuropathic pain is due to abnormal activation of the nociceptive system without specifically stimulating the nociceptors.
Psychogenic – physical pain that is caused, increased or prolonged by mental, emotional or behavioral factors.
Pain processes
The 4 processes of nociception
Transduction – the process where tissue-damaging stimuli activate nerve endings.
Transmission – the process of transferring the pain information from the site of tissue injury to the central nervous system.
Modulation – refers to the pain signals throughout the spinal cord and brain. The signals originating in the brain can reduce or increase the pain signal transmission.
Perception – the subjective awareness associated with a specific area of the body. Perception is a complex function influenced by social and environmental cues as well as past personal experiences
Factors that influence pain perception
The body can switch into two different states, depending on what is happening in our internal or external environment. This is the autonomic nervous system. Parasympathetic (rest and digest) allows the body to digest food and heal properly. Sympathetic (fight and flight) is where our body wants to protect us from harm. When in pain, we are in a sympathetic state. This can be detrimental for those in chronic pain due to the heightened levels of adrenaline, this can increase the pain experience and change the nerves.
Neuroplasticity
Neuroplasticity is where the brain and central nervous system (CNS) has the ability to adapt to our internal and external environment. The brain can learn to be in pain which is no longer beneficial for the person and can become harmful. From this, acute pain can turn into chronic pain.
Chiropractic and Pain
Chiropractic care may be very beneficial for pain management. Chiropractors focus on the spine and nervous system, locating spinal dysfunction (vertebral subluxation) and performing an adjustment to restore healthy movement. Adjusting the spine improves your brain and body communication. From this, the brain will be able to control movements of the body and know when to create the sensation of pain.
Chiropractic adjustments can affect an area in the brain called the pre-frontal cortex. This is where we control our movement, proprioception, autonomic nervous system, make decisions and process pain. This is important because Chiropractic care may help reduce the feeling of pain and an individual’s perception of it.
The brain can learn to be in pain due to neuroplasticity. Due to neuroplasticity, you can re-train your brain to not be in pain. On top of a Chiropractic adjustment, being positive, staying active, having better posture, eating well, and sleeping well are a few tools to help retrain the brain.
Conclusion
In summary, we talked about pain being very subjective depending on an individual’s prior experience. The feeling of pain is created when the body senses danger or injury. If pain is ongoing, it can impact an individual mood and quality of life. The different types of pain consist of: acute, chronic, nociceptive, neuropathic, and psychogenic. We discussed the pain process of nociception and the factors that influence the perception of pain.
The brain can learn to be in pain which is no longer beneficial for the person and can become harmful, this is an example of neuroplasticity. Chiropractic care may be beneficial for reducing the feeling of pain, allowing the body to heal and restore healthy movement.
References
Chiros Academy. (2022). How to explain pain. Retrieved from https://chirosacademy.com/classes/basic-science-level-1/
Haavik, H., Murphy, B. (2012), The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. Journal of Electromyograohy and Kinesiology, 22(5), 768-776. https://doi.org/10.1016/J.JELEKIN2012.02.012
Haavik, H., Niazi, I. K., Holt, K. & Murphy, B. (2017). Effects of 12 weeks of chiropractic care on central integration of dual somatosensory input in chronic pain patients: a preliminary study. Journal of Manipulative and Physiological Therapeutics, 40, 127–138.
Hanoch Kumar, K., & Elavarasi, P. (2016). Definition of pain and classification of pain disorders. Journal of Advanced Clinical & Research Insights, 3(3), 87-90.
Holt, K. Haavik, H., Lee, A. C. L., Murphy, B., & Elley, C. R. (2016). Effectiveness of chiropractic care to improve sensorimotor function associated with falls risk in older people: a randomized control trial. Journal of Manipulative and Physiological Therapeutics, 39(4), 267-278. https://doi.org/10.1016/j.impt.2016.02.003
International Association For The Study Of Pain. (2021). Definition of pain. Retrieved from https://www.iasp-pain.org/publications/iasp-news/iasp-announces-revised-definition-of-pain/
Lelic, D., Niazi, I. K., Holt, K., Jochumsen, M., Dremstrup, K., Yielder, P., Murphy, B., Drewes, A. M., & Haavik, H. (2016). Manipulation of dysfunctional spinal joints affects sensorimotor integration in the prefrontal cortex: a brain source localization study. Neural Plasticity, 2016, 9. https://doi.org/10.1155/2016/3704964
Navid, M. S., Lelic, M., Niazi, I. K., Holt, K., Mark, E. B., Drewes, A. M., & Haavik, H. (2019). The effects of chiropractic spinal manipulation on central processing of tonic pain – a pilot study using standardized low resolution brain electromagnetic tomography. Scientific Reports. (9), 6925. https://doi.org/10.1038/s41598-019-42984-3
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