What is one of the main reasons any individual decides to book in for physiotherapy?
What are the most common questions a physiotherapist will ask upon arrival?
“Do you have any pain…?”
“Where is your pain…?”
“How severe is your pain…?”
But how do we define pain? What exactly is it and why do we feel it?
The Oxford English Dictionary makes reference to noxious (harmful) stimuli and tissue damage with its definition. However, how I like to think of it is more applicable and individually relevant through a quote by McCaffery & Beebe in 1999.
“Pain is what the person says it is, existing whenever the person says it does.”
We know and have seen that two separate athletes can have full ACL ruptures in the same knee and yet one can be in instant agony and the other can keep playing for 15 minutes without even knowing something is terribly wrong. In this case we definitely have quite significant tissue damage, yet the perception of pain is vastly different between the two athletes. Why?
Pain is a complex experience that is based intricately on the contributions of thoughts, emotions and sensations. Therefore it is crucial that we as treating physiotherapists not only understand the elements of the pain gate theory – how pain is actually produced by peripheral and central sensory pathways within the nervous system – but also have a grasp on the biopsychosocial factors of a patient’s life which can reduce, nullify or intensify experiences of pain.