What is Pain? |
“...When I added losing my kids, and becoming homeless to the mix, if there was an 11, I was there...”
From Webster's dictionary;
“pain”, by definition, is: a : usually localized physical suffering associated with bodily disorder (as a disease or an injury); also : a basic bodily sensation induced by a noxious stimulus, received by naked nerve endings, characterized by physical discomfort (as pricking, throbbing, or aching), and typically leading to evasive action b : acute mental or emotional distress or suffering : see GRIEF ( Hmmmm.)
Pain is a very personal thing, different for each person and based upon a lot of complex issues such as common nerve structure, sensitivity, focus and concentration, chemical makeup, genetics, bodily function, just to name a few. With each internal structure there is a list of complex issues. Externally, there is also a list based on each person's uniqueness such as, how they are raised, their work, education, gender, age, culture, religious persuasion, race, marital status, family structure, and much more. With each of these items there is also a complete set of complexities. Why, when I talk about doctors not being able to standardize procedures, or medicines, or therapies they still balk at this. I don't understand. With their education in anatomical structures in the human animal, it seems unbelievable that most professionals have a routine procedure that they know well and prescribe to everyone who walks through the door. This is changing, but not fast enough. At least you, as the pain afflicted, should know and understand that pain is subjective and physical.
Emotions, belief systems and understanding can play a big part in how we feel pain, but regardless, it is there and it is very real. If a doctor, or family member, or friend, or a newspaper report, or television show, tells you that it's in your head, but does nothing to help you relieve it, don't listen to them. Walk out on them, and don't bring it up to them again. They have another agenda. They are not helping, but hurting an already bad situation. Pain is described in many ways, but understand that no human, and no machine and can feel your pain, so we need a system to describe it to others, to help them understand how bad it is, and where it's coming from.
Burning, stabbing, dull, achy, constant drone, sharp, intense, fatiguing, breathtaking, on and on. You can see how frustrating this system is, but it's all we've got right now. In the future, not far from now, there will be a machine that will take pictures of the brain and a doctor will be able to see your pain light up in colors on a TV screen. No one will ever feel your pain, but it will at least be more helpful than “I don't know, it just hurts!” Or the confusing, “it's kind of a dull, stabbing, intensely achy, inconsistent droning pain, a dull burning that makes me tired.”
Pain can be further, and better described, using the words damaging and non-damaging. Yes, it hurts to move, but is it hurting you? Even in a healthy, young person, a good first workout, or a hike in the spring after a long dormant winter can hurt. A lot. Are the muscles sore from inactivity? Are the soft tissues sore from age? Did the person sleep wrong? Or, are they working out in the wrong position and actually damaging tissues? Are they hiking with too much weight, balanced wrong and wearing the wrong shoes, slowly wearing down the structures that hold the knees in place, an accident waiting to happen. Damaging, non-damaging, unless you are an expert in human anatomy, skeletal and nervous systems, you cannot know that it is damaging. It all seems damaging and we fear that its permanent and we avoid that at all costs.
Sometimes, however, pain can be from something that's good for us. Sometimes, stretching and strengthening can cause pain. Non-damaging. As the body heals and creates movement of different tissues, it can cause pain. Non-damaging. It gets far more complex than this. For instance, before my enormous hike I was having a lot of trouble walking at all. Even to go around the couch was causing deep, shocking pain waves that made it hard for me to breathe. I was giving in to this pain by bending slightly forward, which made it feel better and, unknowingly, I was developing a hunched over posture. My therapist told me about it and would make me stand up very straight, which hurt a lot, and I told her that bending forward relieved the pain, and she said, “If you keep doing that, your spine will develop a permanent hunch, but more importantly, it could cause your fractured vertebra to push forward into your lung, and collapse it.”
No matter how much it hurts, I always stand very straight. I learned that bending backwards to a degree is non-damaging pain, so for as long as I can, I will perform the stretch to keep my posture straight and flexible. I am cheating the evil of disease by putting up with some pain. I learned a lot about which pain is which. Non-damaging pain hurts but it isn't hurting me. Everything I do in a given day hurts. If it's damaging pain, I avoid that movement. I figure out ways to get around it. That, to me, is the name of the game, in dealing with pain and physical movement. I don't do anything that would hurt me, but I do a lot of movement that hurts. The next thing to learn about this evil monster, is the Pain Amplifier. (See appendix)
We know the “one to ten scale” well. The doctor says “What is your pain level, on a scale of one to ten, one being no pain, and ten being the worst pain you've ever had in your life.” We roll our eyes and say “Eleven!” or we think to ourselves, “Today, no yesterday was a ten, today is like a nine and a half.” Some people say “Six”, as I watch them squirm and move while they're sitting and talking, their actions making it seem like the pain is worse than just a six. This is the scale that doctors invented to better understand our pain. I'm not really sure how this tells them anything, since no one ever sees what happened to me that causes me to consider my pain to be a ten, or when was the last time I had zero. I think it's strange that if I fill out that little diagram of where it hurts, every time I see a doctor, and every time I put down the same hurt, and the same number seven or eight, that someone would take that seriously and tell me to go to the emergency room. Are these people so jaded to people in pain that a seven to eight, all over the spine, hips and chest, with head pain, would cause them to pass it off and not comment? Or is anybody actually looking at those sheets? Or is that diagram with those numbers just not that big of a deal?
Another standardization of the medical system towards the patient. Not that the one to ten scale is bad, its just not utilized. It should be the beginning topic of conversation in a clinic visit. This is still a usable scale, for us, not so much them, until they learn to understand it better, and realize, as should we, that there's more to it than just saying a number and moving on. Something we, as patients, always get wrong is the “worst pain you've ever had.” People will say their pain is a nine or an eight, then you say “What's your worst pain ever?” and they tell you this horrific story of a car accident, or work-related injury or emergency room trauma, and you look at them and think “if that's their ten, and they're sitting here at eight or nine, Oh my God! Get the stretcher!”
I think we need to scrutinize our numbers better. I used to keep a daily log, hour by hour. After each 30 days, I made a graph, a chart of these numbers with the whole month on one sheet. That's how I learned about the curves of pain and the “Good Day/Bad Day syndrome” that goes with it. I made notes of what I ate, what I did physically, what medicines I took, and when I took them, (what else did I have to do? ), anything that would allow me to measure and observe this pain. I learned a lot about myself from that. I understood the ten scale a lot better after that and I noticed a lot of correlations. This didn't help me medically though, and this needs to be noted so you don't make this mistake either.
My doctors at the time, in Colorado, not Boston, took it completely wrong. First, they became nonchalant about it, saying, “Oh, that's nice, you keep a pain log. Oh, you've even graphed it, how neat.” In reality it scared them. I was a note taker. I was keeping track of everything. So, they used it against me and said that I suffered from anxiety, because I was so “obsessed” with my pain. This caused everyone to get off on another tangent and lead me further down the wrong path. Unfortunately, no one told me these things. I read about them in my files three years later. All that time I thought the doctors and myself were better understanding the pain and learning about my reactions to medicines and nutrition and activity. I thought I was helping them, but I was only scaring them. You can, however, use the one to ten scale to better understand yourself. It is a crude way of putting your pain to a number, but without a record, a pain diary, it's just a number. Remember, a ten is the worst you've ever had in your life.
A doctor will ask you to describe the pain using adjectives. Another crude yet effective way for them to figure out where the pain is coming from. Stabbing, dull, achy, shooting, electric, droning, these all have different meanings to a doctor that translate to nerve, organ, musculoskeletal, brain, major, minor, primary, secondary, the list goes on, but you can see how important this is. Like two people from different countries, speaking different languages, we need some way of communicating with each other. Add to this your body language, which never lies, but can be disastrously misunderstood.
I always shake my leg when the pain is severe, it seems to distract me and confuse the pain signal. Like shaking your hand when you hit your thumb with a hammer, I don't know why, it just helps. This was construed by a doctor as a sign of anxiety, which also led to being called a drug addict, after ten months of testing, which showed bone disease. Boy did that confuse the situation. I now became an “incorrigible drug addict with a mental illness and an anger problem. This actually caused my case to go full circle, two years later, but these unbelievable assessments, based on a misunderstanding, were still used against me and caused me to become homeless.
Yes, it's that serious. Until we change things, you've got to be careful about divulging what you know. So, for your own healing, for the purposes of putting pain into the background, keep a diary, graph it, use the one to ten scale, notice your body language and follow your curves. Good days, bad days, up for three hours, down for four, fetal position when sleeping, handshaking, all of that. You need to start learning about your pain.
I introduced the Pain Amplifier as a way of helping you understand yourself and you're pain more. This is the answer to why pain can come up and control your life. Why your condition can stay the same, but your pain changes all the time. This is a quick summary, as I will include the Pain Amplifier chart as an appendix. Suffice it to say, that the things going on in your life, internal and external, have a way of increasing the noise of pain. How you think and feel, especially as you travel through pain, can directly affect how loud pain is in your life. The negatives turn the volume up, the positives turn it down. For instance, each step in the Pain Cycle (see chart) affects the volume of the Pain Amplifier. If you've experienced say, loss of job, or loss of friends and social activity, turn it up a notch. If you go into resignation, and stay there, keep turning it up. Your family and friends drop subtle hints that you're not really hurt, turn it up. Bill collectors call, your doctor's not paying attention, you boss threatens to fire you, or your kids are being kids, your wife is nagging and you medicines don't work right. Yes, turn it way up! Just like the one to ten scale, this amplifier also has one to ten. When I went through four years of negativity, with all of this happening over that time, (except the nagging wife, I was a single father.) , my amplifier was at a nine or ten. When I added losing my kids and becoming homeless to the mix, if there was an 11, I was there.
Not only was I adverse to any help, such as treatments or therapy, the pain was so loud, that the one to ten scale pain, which was six to seven, was crippling me. Contrast this with now. I've graduated the curve of the Pain Cycle. I've been slowly turning the volume of the amplifier down and down until now, it is a one or two. My one to ten scale pain is higher, due to the deterioration of my condition, and normally runs an average of seven to eight, and I just walked three thousand miles, with one hundred pounds of gear, with little or no damage to myself, and with that same seven or eight pain. It would take a ten for me to go to the hospital, if it was a damaging ten, or pain I didn't understand.
I am still, as of this writing, in a very tough situation with a lot of negativity, financial, environmental, my future, but the effects of the one to ten scale pain is less! I did these “walks” for all of you, and me. I did it to prove that this is the truth, that it works. I did it to show you the difference between an eight on the Pain Amplifier scale, and a two. I did it at the sacrifice of my own attempts to gain understanding from society and its institutions. I seriously confused my situation with Social Security, and my doctors, and my friends and family. Everyone sees my attitude, my energy, and my demeanor and assumed I'm over it. That's okay. I don't need validation anymore, because the fact is, like it or not, I did it!
We, as people in pain, are the only ones who need to know this, and we may be the only ones who could really understand it. To me, the huge difference in my life, the thing that allows me freedom, and happiness, and life satisfaction, is the Pain Amplifier, and I am living to tell the tale, that if you take the steps towards reinvention and positivity, you can turn it down, and learn this important step to putting pain in the background, for good. As you can see, taming that monster called pain, can be accomplished. Understanding the Pain Cycle that you involuntarily entered, knowing that you can get through it to the other side. Knowing what pain is, how it functions, damaging and non-damaging pain, the Pain Amplifier, all of this gaining of knowledge allows you to demystify pain, to better control it, and to know that you have the power over it, despite the system.
You have heard my story and I'll bet it's similar to yours. You have read about negative and positive attitudes and how this understanding controls pain's negativity in your life. Now you've started an understanding of what pain is and how to better know its control over you. You're about to go on a journey of knowledge, and hopefully, empowerment.
This is a journey you must first accept. You must dedicate yourself to the studies. You must take the steps. Small, steady, accomplished steps to getting your life back. If you really want out of pain, you will accept this role of the true professional pain patient. Next, you will read about loss, and you'll uncover the secrets of the negative side of the Cycle. This gets pain very upset as he knows, the more power over it you acquire the more its days are numbered, but believe me, even when you're on the positive side, it will never give up without a fight. Are you ready??
From Webster's dictionary;
“pain”, by definition, is: a : usually localized physical suffering associated with bodily disorder (as a disease or an injury); also : a basic bodily sensation induced by a noxious stimulus, received by naked nerve endings, characterized by physical discomfort (as pricking, throbbing, or aching), and typically leading to evasive action b : acute mental or emotional distress or suffering : see GRIEF ( Hmmmm.)
Pain is a very personal thing, different for each person and based upon a lot of complex issues such as common nerve structure, sensitivity, focus and concentration, chemical makeup, genetics, bodily function, just to name a few. With each internal structure there is a list of complex issues. Externally, there is also a list based on each person's uniqueness such as, how they are raised, their work, education, gender, age, culture, religious persuasion, race, marital status, family structure, and much more. With each of these items there is also a complete set of complexities. Why, when I talk about doctors not being able to standardize procedures, or medicines, or therapies they still balk at this. I don't understand. With their education in anatomical structures in the human animal, it seems unbelievable that most professionals have a routine procedure that they know well and prescribe to everyone who walks through the door. This is changing, but not fast enough. At least you, as the pain afflicted, should know and understand that pain is subjective and physical.
Emotions, belief systems and understanding can play a big part in how we feel pain, but regardless, it is there and it is very real. If a doctor, or family member, or friend, or a newspaper report, or television show, tells you that it's in your head, but does nothing to help you relieve it, don't listen to them. Walk out on them, and don't bring it up to them again. They have another agenda. They are not helping, but hurting an already bad situation. Pain is described in many ways, but understand that no human, and no machine and can feel your pain, so we need a system to describe it to others, to help them understand how bad it is, and where it's coming from.
Burning, stabbing, dull, achy, constant drone, sharp, intense, fatiguing, breathtaking, on and on. You can see how frustrating this system is, but it's all we've got right now. In the future, not far from now, there will be a machine that will take pictures of the brain and a doctor will be able to see your pain light up in colors on a TV screen. No one will ever feel your pain, but it will at least be more helpful than “I don't know, it just hurts!” Or the confusing, “it's kind of a dull, stabbing, intensely achy, inconsistent droning pain, a dull burning that makes me tired.”
Pain can be further, and better described, using the words damaging and non-damaging. Yes, it hurts to move, but is it hurting you? Even in a healthy, young person, a good first workout, or a hike in the spring after a long dormant winter can hurt. A lot. Are the muscles sore from inactivity? Are the soft tissues sore from age? Did the person sleep wrong? Or, are they working out in the wrong position and actually damaging tissues? Are they hiking with too much weight, balanced wrong and wearing the wrong shoes, slowly wearing down the structures that hold the knees in place, an accident waiting to happen. Damaging, non-damaging, unless you are an expert in human anatomy, skeletal and nervous systems, you cannot know that it is damaging. It all seems damaging and we fear that its permanent and we avoid that at all costs.
Sometimes, however, pain can be from something that's good for us. Sometimes, stretching and strengthening can cause pain. Non-damaging. As the body heals and creates movement of different tissues, it can cause pain. Non-damaging. It gets far more complex than this. For instance, before my enormous hike I was having a lot of trouble walking at all. Even to go around the couch was causing deep, shocking pain waves that made it hard for me to breathe. I was giving in to this pain by bending slightly forward, which made it feel better and, unknowingly, I was developing a hunched over posture. My therapist told me about it and would make me stand up very straight, which hurt a lot, and I told her that bending forward relieved the pain, and she said, “If you keep doing that, your spine will develop a permanent hunch, but more importantly, it could cause your fractured vertebra to push forward into your lung, and collapse it.”
No matter how much it hurts, I always stand very straight. I learned that bending backwards to a degree is non-damaging pain, so for as long as I can, I will perform the stretch to keep my posture straight and flexible. I am cheating the evil of disease by putting up with some pain. I learned a lot about which pain is which. Non-damaging pain hurts but it isn't hurting me. Everything I do in a given day hurts. If it's damaging pain, I avoid that movement. I figure out ways to get around it. That, to me, is the name of the game, in dealing with pain and physical movement. I don't do anything that would hurt me, but I do a lot of movement that hurts. The next thing to learn about this evil monster, is the Pain Amplifier. (See appendix)
We know the “one to ten scale” well. The doctor says “What is your pain level, on a scale of one to ten, one being no pain, and ten being the worst pain you've ever had in your life.” We roll our eyes and say “Eleven!” or we think to ourselves, “Today, no yesterday was a ten, today is like a nine and a half.” Some people say “Six”, as I watch them squirm and move while they're sitting and talking, their actions making it seem like the pain is worse than just a six. This is the scale that doctors invented to better understand our pain. I'm not really sure how this tells them anything, since no one ever sees what happened to me that causes me to consider my pain to be a ten, or when was the last time I had zero. I think it's strange that if I fill out that little diagram of where it hurts, every time I see a doctor, and every time I put down the same hurt, and the same number seven or eight, that someone would take that seriously and tell me to go to the emergency room. Are these people so jaded to people in pain that a seven to eight, all over the spine, hips and chest, with head pain, would cause them to pass it off and not comment? Or is anybody actually looking at those sheets? Or is that diagram with those numbers just not that big of a deal?
Another standardization of the medical system towards the patient. Not that the one to ten scale is bad, its just not utilized. It should be the beginning topic of conversation in a clinic visit. This is still a usable scale, for us, not so much them, until they learn to understand it better, and realize, as should we, that there's more to it than just saying a number and moving on. Something we, as patients, always get wrong is the “worst pain you've ever had.” People will say their pain is a nine or an eight, then you say “What's your worst pain ever?” and they tell you this horrific story of a car accident, or work-related injury or emergency room trauma, and you look at them and think “if that's their ten, and they're sitting here at eight or nine, Oh my God! Get the stretcher!”
I think we need to scrutinize our numbers better. I used to keep a daily log, hour by hour. After each 30 days, I made a graph, a chart of these numbers with the whole month on one sheet. That's how I learned about the curves of pain and the “Good Day/Bad Day syndrome” that goes with it. I made notes of what I ate, what I did physically, what medicines I took, and when I took them, (what else did I have to do? ), anything that would allow me to measure and observe this pain. I learned a lot about myself from that. I understood the ten scale a lot better after that and I noticed a lot of correlations. This didn't help me medically though, and this needs to be noted so you don't make this mistake either.
My doctors at the time, in Colorado, not Boston, took it completely wrong. First, they became nonchalant about it, saying, “Oh, that's nice, you keep a pain log. Oh, you've even graphed it, how neat.” In reality it scared them. I was a note taker. I was keeping track of everything. So, they used it against me and said that I suffered from anxiety, because I was so “obsessed” with my pain. This caused everyone to get off on another tangent and lead me further down the wrong path. Unfortunately, no one told me these things. I read about them in my files three years later. All that time I thought the doctors and myself were better understanding the pain and learning about my reactions to medicines and nutrition and activity. I thought I was helping them, but I was only scaring them. You can, however, use the one to ten scale to better understand yourself. It is a crude way of putting your pain to a number, but without a record, a pain diary, it's just a number. Remember, a ten is the worst you've ever had in your life.
A doctor will ask you to describe the pain using adjectives. Another crude yet effective way for them to figure out where the pain is coming from. Stabbing, dull, achy, shooting, electric, droning, these all have different meanings to a doctor that translate to nerve, organ, musculoskeletal, brain, major, minor, primary, secondary, the list goes on, but you can see how important this is. Like two people from different countries, speaking different languages, we need some way of communicating with each other. Add to this your body language, which never lies, but can be disastrously misunderstood.
I always shake my leg when the pain is severe, it seems to distract me and confuse the pain signal. Like shaking your hand when you hit your thumb with a hammer, I don't know why, it just helps. This was construed by a doctor as a sign of anxiety, which also led to being called a drug addict, after ten months of testing, which showed bone disease. Boy did that confuse the situation. I now became an “incorrigible drug addict with a mental illness and an anger problem. This actually caused my case to go full circle, two years later, but these unbelievable assessments, based on a misunderstanding, were still used against me and caused me to become homeless.
Yes, it's that serious. Until we change things, you've got to be careful about divulging what you know. So, for your own healing, for the purposes of putting pain into the background, keep a diary, graph it, use the one to ten scale, notice your body language and follow your curves. Good days, bad days, up for three hours, down for four, fetal position when sleeping, handshaking, all of that. You need to start learning about your pain.
I introduced the Pain Amplifier as a way of helping you understand yourself and you're pain more. This is the answer to why pain can come up and control your life. Why your condition can stay the same, but your pain changes all the time. This is a quick summary, as I will include the Pain Amplifier chart as an appendix. Suffice it to say, that the things going on in your life, internal and external, have a way of increasing the noise of pain. How you think and feel, especially as you travel through pain, can directly affect how loud pain is in your life. The negatives turn the volume up, the positives turn it down. For instance, each step in the Pain Cycle (see chart) affects the volume of the Pain Amplifier. If you've experienced say, loss of job, or loss of friends and social activity, turn it up a notch. If you go into resignation, and stay there, keep turning it up. Your family and friends drop subtle hints that you're not really hurt, turn it up. Bill collectors call, your doctor's not paying attention, you boss threatens to fire you, or your kids are being kids, your wife is nagging and you medicines don't work right. Yes, turn it way up! Just like the one to ten scale, this amplifier also has one to ten. When I went through four years of negativity, with all of this happening over that time, (except the nagging wife, I was a single father.) , my amplifier was at a nine or ten. When I added losing my kids and becoming homeless to the mix, if there was an 11, I was there.
Not only was I adverse to any help, such as treatments or therapy, the pain was so loud, that the one to ten scale pain, which was six to seven, was crippling me. Contrast this with now. I've graduated the curve of the Pain Cycle. I've been slowly turning the volume of the amplifier down and down until now, it is a one or two. My one to ten scale pain is higher, due to the deterioration of my condition, and normally runs an average of seven to eight, and I just walked three thousand miles, with one hundred pounds of gear, with little or no damage to myself, and with that same seven or eight pain. It would take a ten for me to go to the hospital, if it was a damaging ten, or pain I didn't understand.
I am still, as of this writing, in a very tough situation with a lot of negativity, financial, environmental, my future, but the effects of the one to ten scale pain is less! I did these “walks” for all of you, and me. I did it to prove that this is the truth, that it works. I did it to show you the difference between an eight on the Pain Amplifier scale, and a two. I did it at the sacrifice of my own attempts to gain understanding from society and its institutions. I seriously confused my situation with Social Security, and my doctors, and my friends and family. Everyone sees my attitude, my energy, and my demeanor and assumed I'm over it. That's okay. I don't need validation anymore, because the fact is, like it or not, I did it!
We, as people in pain, are the only ones who need to know this, and we may be the only ones who could really understand it. To me, the huge difference in my life, the thing that allows me freedom, and happiness, and life satisfaction, is the Pain Amplifier, and I am living to tell the tale, that if you take the steps towards reinvention and positivity, you can turn it down, and learn this important step to putting pain in the background, for good. As you can see, taming that monster called pain, can be accomplished. Understanding the Pain Cycle that you involuntarily entered, knowing that you can get through it to the other side. Knowing what pain is, how it functions, damaging and non-damaging pain, the Pain Amplifier, all of this gaining of knowledge allows you to demystify pain, to better control it, and to know that you have the power over it, despite the system.
You have heard my story and I'll bet it's similar to yours. You have read about negative and positive attitudes and how this understanding controls pain's negativity in your life. Now you've started an understanding of what pain is and how to better know its control over you. You're about to go on a journey of knowledge, and hopefully, empowerment.
This is a journey you must first accept. You must dedicate yourself to the studies. You must take the steps. Small, steady, accomplished steps to getting your life back. If you really want out of pain, you will accept this role of the true professional pain patient. Next, you will read about loss, and you'll uncover the secrets of the negative side of the Cycle. This gets pain very upset as he knows, the more power over it you acquire the more its days are numbered, but believe me, even when you're on the positive side, it will never give up without a fight. Are you ready??