Kelsey Crispeno Kelsey Crispeno

What is pain?

What is pain? Why does it matter that we understand pain? 

This is a tough one to put in one post. 

Pain is nuanced, complex, and individual.

Your pain experience is individual and unique to you.

However, we (the collective, societal, “we”) have made pain scary. We have made pain something to run and hide from; we have made pain something to try to get rid of and avoid at all costs. 

Ah, but it’s not.

What is pain? Why does it matter that we understand pain? 

This is a tough one to put in one post.

Pain is nuanced, complex, and individual.

Your pain experience is individual and unique to you.

However, we (the collective, societal, “we”) have made pain scary. We have made pain something to run and hide from; we have made pain something to try to get rid of and avoid at all costs. 

Ah, but it’s not.

Let me begin by telling you a story.

When I was in my freshman year of high school, my grandparents came to live with us. They lived with us for nearly 7 months so that my grandmother could get care for her back pain.

Her back pain had completely uprooted and turned over her life. She would describe the pain as >8/10 (10, being the worst) at nearly all times. I remember at one point that she was taking deadly levels of opioids to manage and control the pain. I tell you this not to divulge the entire, deeply painful story (yes, for her, but also for the rest of the family & my grandfather) that cascaded from here, but to illustrate the origin of my fascination with pain and the experience of pain.

I ended up in physical therapy school getting my doctoral degree in physical therapy without much understanding or context for how or why or what it was exactly that got me there. I knew (and still know) that I have a passion for movement, health, and helping people move to live. However, it was not until after graduating with my doctorate and sitting in my therapist’s office that I finally put the pieces together: my story with pain is why I became a physical therapist.

My story with pain is why I have been on this non-traditional career path since, where I am running two different businesses in fitness & health, and always dreaming about the next thing to create or set-in-motion.

But, this story is not about me.

The story is that pain shapes and molds us all in some way or another.

The story is that pain is not just sensory and physical. Pain is emotional, relational, dynamic. Pain is in our DNA – it is one of our keys to survival. If we did not experience pain, we would not survive. I have firsthand experience with bodily pain alerting me to something that needed to be dealt with medically– and had it not, I (most likely) would not be here.

However, I think our society really misunderstands pain.

When pain shows up, the pain invites us to look at it. There is neuroscience behind this! If you are interested in learning more about the neuroscience of pain – there are great resources out there. I recommend Curable to many people.

Pain is our body’s very sophisticated alarm system that tells us when it thinks something is up. Hint, when it thinks something is up. 

There are a lot of super fascinating, peer-reviewed studies that now exist that disprove the medical theory that physical pain = damage. It does not. Recent imaging studies demonstrate that an image cannot predict whether or not someone has back pain (images of lumbar spines with abnormalities do not correlate to someone experiencing pain when compared to images of lumbar spines without abnormalities).¹

In my work with patients in physical therapy, especially those experiencing chronic pain, there are often many layers to their pain. Their pain is physical, yes, but it is also emotional pain. The pain that they experience (and maybe, you, too, experience or have experienced) is often related to pain (emotional or relational or physical) experienced in their growing up years. Again, neuroscience tells us that our experience of pain is shaped by our family influences, our beliefs about pain, our fears, our desires, and other physiological and contextual variables.

The great news about this is that our nervous system guides pain. And, our nervous system(s) are very plastic (meaning, our nervous systems can change and adapt their function and structure - physical structure - based on new information and experiences). 

Pain is a universal experience that binds us all. You are not alone in your pain. 

Most often, healing from pain requires community and connection to others. Our nervous systems need safety. We experience pain via disconnection with others, but can heal, adapt  and rewire (plasticity!) via connection with others.

So, today, I invite you to be curious about pain.

Here are some questions for reflection: 

  • What are your current beliefs about pain? Is pain bad? Is pain good?

  • Can you recall a time where pain was helpful to you in some way?

  • What did your parents or primary caregivers teach you about pain?

  • What have you learned about pain in the current medical system?

  • Consider asking any physical pain this question: what are you telling me right now?

You are not alone.

Dr. Kelsey C Garvey, PT

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References

  1. Low back pain: a call for action
    Buchbinder, RachelleBuchbinder, Rachelle et al.
    The Lancet, Volume 391, Issue 10137, 2384 - 2388

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