Pain; what is it?
Mark Tawn discusses
At some time in our lives most of us experience it.
But just what is pain?
My English dictionary provides the definition as:
“Physical hurt or discomfort caused by injury or illness….emotional suffering or mental distress.”
Interestingly, my concise medical dictionary doesn’t include a definition. Perhaps this is because the answer is far from straightforward.
IASP, the International Association for the Study of Pain defines it as:
“An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”.
The notes to this definition continue:
“…Pain is always subjective…It is unquestionably a sensation in a part or parts of the body, but it is always unpleasant and therefore also an emotional experience….Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons. There is usually no way to distinguish their experience from that due to tissue damage if we take the subjective report. If they regard their experience as pain, and if they report it in the same ways as pain caused by tissue damage, it should be accepted as pain.”
In the context of having suffered an accident my clients often report pain to many different people. These may include:
- Emergency service personnel – paramedics, ambulance crew, police or fire crew
- Hospital staff – A&E, nurses, orthopaedic, neurology, rheumatology or pain management
- Family and friends
- Employers and colleagues
- DWP/welfare benefits personnel
How is pain described?
I have heard (and read) hundreds of different expressions and words from many different clients to describe their feelings, these include:
Ongoing, constant, periodic, occasional, permanent, regular, worsening, mild, moderate, bad, terrible, awful, agonising, excruciating, burning, gnawing, stabbing, niggling, exhausting, freezing, deep, like toothache, worse than having a baby, the worst agony I’ve ever had.
How does pain affect people?
Because it is subjective it affects different people in different ways.
One client who had to have surgery without any anaesthetic, when asked about his experience brushed it aside saying: “worse things happened during the war.”
Another, who had suffered a low velocity road traffic collision, was in “constant agony” which continued, unabated, for years despite all sorts of treatment: medication and injections, physical therapy and psychological therapy. The same client underwent investigations which included X-rays and MRI scans which revealed no underlying bony injury (e.g. a break or fracture), nor any soft tissue damage that would account for the reported symptoms.
For how long does pain last?
It may be short-lived. This is referred to as acute pain.
Long term pain, which has lasted for three months or more, is widely referred to as chronic pain.
What types are there?
Nociceptive pain occurs when nerves which sense and respond to parts of the body are activated (usually by damage) transmitting signals to the brain. When the damage heals the pain usually ceases.
Neuropathic pain results from injury to or a problem with the nervous system. The injury may not actually include damage to the nerves. The experience of pain continues beyond the apparent healing of damaged tissue. The system itself is (or has become) dysfunctional.
Pain may be experienced owing to a mix of neuropathic and nociceptive factors and can be complicated by psychological and social issues.
Why might other issues affect me?
If one is suffering and it isn’t getting better (or worsening) all sorts of questions can arise: Who will take the kids to school? Might I lose my job? How will I pay the bills? This can cause worry, anxiety, fear, and may lead to depression. This can be a downward spiral:
Pain → worry → more pain → more worry
The degree of discomfort experienced can also be influenced by broader social issues. Absence from work can cause problems with employers, the need to claim benefits, to find help from charities and so on. It can affect relationships: feeling or becoming needy or dependent; partners becoming carers as opposed to lovers and withdrawal or alienation from family and friends.
In a compensation claim if you have long term pain it is vitally important that your solicitor discusses these issues with you and those nearest to you.
If you have a complex claim talk to us: Seriousinjury.expert