Naming Pain

Feb 16

Pain – the complex, brain generated phenomenon. A subjective experience that varies from person to person, and from moment to moment. We have all felt it to some degree, and one thing that unifies almost all experiences of pain is that it does not feel good. Pain comes packaged in many different varieties, making it difficult to reduce into a digestible set of words and phrases. Despite the complexities of pain, researchers and health professionals around the world have found that there are some central trends governing our understanding. My hope is to share some of these trends, beginning in this article with some basic ways that pain is perceived in a patient/practitioner interaction.

Clinical Pain: Acute vs. Chronic

When describing pain, there are two categories you might hear in a clinical setting: acute and chronic.

Acute pain typically occurs rapidly, and dissipates with time and healing. It can be seen as a protective response, seemingly communicating “give me a rest or I will hurt more.” For example, when someone sprains their ankle - swelling, bruising, and intense pain occur. When they go get an X-Ray, the doctor diagnoses it as an acute ankle sprain.

On the other hand, chronic pain is very complicated, and is typically experienced over long periods of time due to repetitive injuries, biopsychosocial factors, and/or underlying conditions such as cancer or arthritis. When health professionals label a condition as chronic, that is their way of communicating that there are numerous underlying factors leading to the patient’s experience of pain. For example, the person who sprained their ankle above does not follow the doctor’s advice to stay on crutches and go to physical therapy, so one year later they still experience some of the same pain, which could be due to many different things. And when they go see a doctor, the doctor would say they have chronic pain.

Communicating Pain

An aim I have as a practitioner is to treat conditions that revolve around pain, while also building a common understanding of a client’s current experience. Providing a more diverse word bank of descriptors and asking relevant questions are an essential part of treatment, and together we construct a story of what is happening in the client’s body. We do this by determining certain factors that might contribute to pain, and certain words that come to mind in relation to the experience.

Some useful things I like to find out about a client’s experience are:

History of injuries, traumas, etc
Location(s) of pain
1-10 scale of pain with and/or without pressure or through specific movements
What activities pain prevents you from doing
What activities make pain better or worse
How often does pain occur, and for how long

Some words that are relevant in describing pain:

Sharp: a sudden, spike of pain
Dull: persistant, constant pain
Aching: local pain, low to moderate levels
Burning: hot, searing, could feel “nervy”
Numb: loss of feeling or sensation
Shooting: sudden severe pain
Splitting: common with headaches
Throbbing: recurring achy pain

In a later article, we will explore how pain works on a physiological level.

Naming Pain

Massage Therapy Benefits: Pain