What is Pain?
(a summary and discussion from Living Beyond Your Pain by Dahl & Lundgren 2006)
Pain = according to the International Association for the Study of Pain it is an “unpleasant sensory and emotional experience” that is “associated with actual or potential tissue damage or described in terms of such damage”
What does this definition mean? It tells you nothing can be measured objectively, that is, there is no measure of pain that can be universally applied. Have you been hurt by falling off your bike and grazing your knee? Anyone who has such stories from their childhood can tell you that it is unpleasant (to say the least).
But just how much emotional and sensory experience is required before an unpleasant sensation becomes defined as pain? Is this term held only for the realm of physical or can it be applied in the same manner to emotional or psychological issues? Back to our bike example. We have ascertained that the fall results in a grazed knee which results in pain, and according to this definition we know why – it is the damage to the tissue of the knee sustained during the fall that resulted in our pain. Not only this, but we didn’t even need to have grazed our knee for pain to occur. How? It’s the potential for damage to occur. Let’s say you fell off your bike, but somehow managed to come away unscathed. Your experience in itself can result in a sensation and emotional experience that you attribute to “pain”.
Thus, there is actual and potential damage. Gotcha.
But what about the final murky bit at the end of the definition? That the unpleasant sensory and emotional experiences only need to be “described in terms of” tissue damage? What on earth does this mean and how can it be compared (if at all) to patients with pain resulting from actual tissue damage? This is the real Achilles heel of the western medical system’s response to pain and is my real bug bear.
We should summarise the definition as this: your pain is yours to experience and feel and it is unlike anyone else anywhere. This subjectivity is what makes us all unique, but frustratingly, also comes with its own set of unique problems. How do we approach treating pain when everyone’s is different?
More on that tomorrow…. :)
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