The purpose of pain

What is the purpose of pain? Why does it persist? What is pain? These are some of the questions we ask to investigate pain, understand pain and help others manage and overcome their pain. This is also an important start point for the person suffering pain, you. To understand means that you will see the potential and opportunities to shape a positive future. This, from wherever your start point.
I have intentionally kept the points brief. They are in no particular order. There are a few as it is a wildly complex topic that draws on many fields.
As a suggestion, you may like to get yourself a cup of coffee or something else, sit down if you can, and take your time to read through. You may like or need to do this in several sittings.
If you have questions, please do bring them along to your session.
  1. Pain is one of the largest global health burdens affecting millions and costing billions.
  2. Pain is protective and part of the way we can survive.
  3. Pain is always real, but often difficult to describe. You should use whatever words come to mind.
  4. Pain is not well related to the extent of the injury.
  5. Pain is whole person — it is not in the brain. It involves the brain, but it is a perception arising via the fact that we have a brain and a body as a whole.
  6. It is the person who perceives pain, not the body area or part. As therapists, we help, guide, treat and encourage a person, not a leg, back or anything else that is less than the whole.
  7. Pain is one of many perceptions that we experience. It can however, become very dominant in cases of sensitivity.
  8. There are many things that influence pain perception. They include: where your attention lies, your expectations (conscious, but mainly subconscious, ie/ what has come before, or priors), your emotional state, who you are with, what you are and have been doing, what you might do, where you are, your language (vocally and the inner dialogue), past experiences, how you breathe, diet, energy levels, sleep quality, whether you feel a sense of purpose, general health, other painful problems and more. Understanding what influences your pain means that you can gain control by focusing on improving those factors. There is much you can do, often with help and guidance to begin with.
  9. Pain is a need state like hunger or thirst. It is a message that something needs to be done to restore balance and harmony in your body and in your life. The brain budgets our resources, anticipating what we need. The things we perceive motivate us to restore a balance. If you are tired due to a bad night sleep (withdrawal from the budget), then you need to create some good habits around bedtime or make time for rest and recovery (deposit).
  10. Pain is embodied. We perceive pain in our bodies, where our attention is drawn.
  11. Pain is embedded within the context of our lives, the environment, the society and culture in which we live. Pain is very individual.
  12. Pain can compel and motivate action. It should not be ignored as there is a reason why you are feeling pain. Instead we can ask ourselves, what are my needs right now? How can I best meet them?
  13. When pain persists, it is unlikely to be down to the original injury or problem now.
  14. Most of the biology of pain is not where you feel it. There is no specific pain biology. There are no pain signals or messages. Pain is a perception predicted by the brain as it’s best guess about what is going on right now according to your needs and body budgeting. Pain emerges from a particular biological state in your body (you have no direct access to your inner workings of course). This includes interrelated activity in your nervous system, immune system, autonomic nervous system, endocrine system, musculoskeletal system and more. Most of this is not where you feel it. Hence the need for treatment and practices that go well beyond where it hurts for successful outcomes.
  15. When pain changes, your state has changed. What did you do to change state? Either changed your biology by moving, changed your focus or changed your language (what you tell yourself), or all of the above.
  16. The more we focus on ‘treating’ the bit that hurts, the worse the outcome. The more we focus on the person and helping them build wellness and achieve their picture of success, the better the outcome. Is my experience of many years working with people suffering chronic pain and health issues who want to improve their lives.
  17. There are many reasons why we can feel pain. We tend to choose one story that makes sense and stick to it despite there being infinite alternatives. Thoughts are real but often wrong.
  18. Pain is related to the perception of threat. When our body systems that detect danger are stimulated, we respond just in case. In most cases, there is no actual danger. But there might be, based on what we know. Reducing the threat is a key strategy and there are many ways to do this.
  19. When you understand your pain, it is easier to focus on the concrete things that you can do to get better.
  20. Pain does many things. In other words, there are many answers to the questions: what is pain? And what is pain for? Here are some more:
    • pain stops us doing things or makes us cautious
    • pain gets us to move, eg/ if we have sat too long
    • to test different movements
    • variably affects our mood and behaviour
    • pain can come and so in surprising ways — something can hurt one minute and not the next
    • pain behaviours help us communicate to others that we need help or to keep away!
    • focuses our attention on our body and reminds us what is important in our life
    • pain teaches us about what might be dangerous
    • tells us to take it easy and recharge the batteries
    • stop! Sometimes
  21. There are needs to be met and things to do in your life to get better, build wellness, improve life and move on. That is the purpose of Pain Coaching.

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