Pain is an unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse. Some pains are easy to understand because there is obvious injury such as bleeding or a bruise. Some are less obvious. Short-term pain like an ankle sprain is called acute pain; long-term, continuous pain is called persistent or chronic pain, while pain that comes and goes is called recurrent or intermittent.
Many acute pains are a useful alarm signal that something is wrong. Most minor ones may be easy to rub better or treat yourself; others may be a sign of something more serious such as a broken leg. The pain is useful because it ensures that you rest the leg until the break has had a chance to heal.
Persistent pain is different from acute pain. The warning system goes into overdrive and sends out repeated pain signals which are not needed or are out of proportion so they serve no useful purpose.
All pain signals travel from the painful part of the body along nerve fibres through the spinal cord to the brain. The spinal cord does not just pass on nerve messages but processes them. In persistent pain, sorting mechanisms for nerve messages go wrong and the brain is confused. This may lead to changes in the pain processing system. Cells that were previously “asleep”, may become “awake” and start sending pain signals to the brain all the time. This is called “wind- up” and is one of the reasons why chronic pain does not go away easily, even if the cause of the pain is discovered and treated. This can lead to a long term, distressing problem.
Pain signals are also processed in the brain where they connect with emotional centres such as anxiety, sleep and appetite centres. The brain sends signals back to the spinal cord, which can, in turn, reduce or increase the pain further. Pain is never “just in the mind” or just in the body; it is a complex interweaving of pain signals and their interpretation by the brain.
The situation in which we receive painful stimuli also make a difference to the way we feel pain. In the heat of the moment even a severe and subsequently painful injury may go unnoticed, for instance if we are involved in an exciting sports match. We might not realise how serious a cut is until we look at it. On the other hand, if we are stressed or depressed we may not be able to stand even a small amount of pain, it becomes overwhelming and makes us feel even more depressed.
Only the person in pain can really say how painful something is as pain is personal and subjective. No two people experience it in the exactly the same way. That makes it very difficult to define. Unfortunately, there is more to persistent pain than just hurting. This is unpleasant enough by itself but when it continues for a long time, it can affect all aspects of your life. It may affect your ability to work, your personal relationships with family and friends, your activity levels and your sleep. About 50% of sufferers become depressed and anxious.
Yes, there is a range of pain killers, of different strengths, available to treat various types of pain. For detailed or individual advice we suggest that you contact your GP, local pharmacist of other healthcare professional.
Exercise – even simple everyday exercise like walking, swimming or dancing – helps boost your general health, strength and balance and can also ease pain directly by blocking pain signals much as ‘rubbing it better’ can.
You can be referred to a specialised Pain Clinic through your GP or hospital doctor. There are clinics in all the major hospitals in Ireland.
You can ask your GP to arrange a second opinion either from a specialist or another GP. This is at the GPs discretion.
There are a number of voluntary organisations that may be able to help with your condition; see our links section for details.
This is difficult to answer for an individual. In general, X-rays take a picture of the bones. They are used for diagnosing arthritis and osteoporotic collapse, mechanical problems or growths in the bones.
An MRI scan also take a picture of the body. MRI scans of the spine may be done to identify soft tissue swellings or injury and slipped discs. They help identify the level of the problem. MRI scans do not show why someone has pain. Unfortunately, although they are one of the most detailed investigations that we have today, they cannot tell a patient exactly what is causing their pain.
Depression is a very common feeling amongst people suffering pain for a long time. In the first instance you should contact your GP for advice on local services.
Musculoskeletal pain is pain felt in the muscles or bones of the body.
Nociceptive pain is pain that occurs due to tissue damage or inflammation.
It is sometimes called “Nerve Pain”. Neuropathic pain is pain initiated or caused by a primary problem in the nervous system. Examples include, pain following shingles, or an amputation, or spinal cord injury. Pain that occurs in people with diabetics or in patients with multiple sclerosis can also be neuropathic.
Epidural steroid injections are one of a number of procedures or injections that may be offered for some types of back pain. The doctor offering you the injection should give you verbal and written information about it before the procedure is done.