By Jennifer Brown
The Pain Chronicles: Defining Pain, Types of Pain, and the Pain Cycle
Pain is something everyone experiences at some point in their life. When pain becomes chronic, however, its once distracting and mildly bothersome characteristics can act as severe and even debilitating impediments affecting daily living activities and depleting one's quality of life. Depending upon the reason for one's chronic pain, pain severity, and quality can be affected by factors such as temperature, emotions, stress, sleep, and nutrition. Accordingly, different types of pain can interact with these factors and contribute to physical and psychological symptoms. The following is a brief introduction to pain, its types, the cycle of pain, and its relationship to our psychological well-being and emotional health.
What is Pain?
Per Cosio (2020), pain is a hard-wired threat often triggered by competing bodily demands. Pain can often be due to injury and is described as a sensory experience or how the body reacts to sensory stimuli (Cosio, 2020). Notably, the experience of pain can be described differently for different individuals, as one’s personal and interpersonal experiences, background, and overall interpretation of pain can ultimately affect how pain is felt. However, when pain persists beyond the average tissue healing time (approximately three months), it can lead to increased distress and suffering and mood, sleep, and lifestyle changes (Mills et al., 2019).
Types of pain
Pain can be separated into distinct bodily categories. For example, pain can be neuropathic, involving the brain and spinal system, or nociceptive, arising from tissue injuries (Dydyk & Conermann, 2023). Pain can also be musculoskeletal or result in back or musculature-related pain; pain can also be inflammatory due to specific autoimmune disorders or from infection, as well as mechanical, caused by joints, discs, vertebrae, or soft tissues (Dydyk & Conermann, 2023). Pain can also be psychogenic, caused by emotional, psychological, and behavioral factors (Dydyk & Conermann, 2023). Examples of psychogenic pain include headaches or abdominal pain due to extreme stress.
The Cycle of Pain
Pain also tends to occur in cycles. According to the American Institutes for Research (2021), several reasons can trigger chronic pain. Anything from new stressors, nutrition and diet, physical activity, and emotional states can aggravate pain. Specifically, once chronic pain starts, it often leads to a domino effect of physical, emotional, and behavioral reactions. For instance, pain often leads to muscle tension, which can stress the body and cause fatigue (AIR, 2021). Once the body is fatigued, the mind takes on more stress, leading to emotional reactions such as anger, fear, and frustration. These reactions are often due to frustration at coping with pain (AIR, 2021). Not surprisingly, these emotional reactions can contribute to depression, sleep and eating changes, and overall lifestyle changes to try to reduce and manage pain (AIR, 2021).
Per AIR (2021), the wellness cycle plays an integral part in helping individuals manage chronic pain and helping to reduce precipitating pain factors that may lead to worsening pain. This cycle includes self-management techniques that better manage pain, reduce muscle tension, improve sleep and comfort, and lead to better moods (AIR, 2021). These techniques will be covered later on in this pain series.
In sum: Pain and Psychology are Interrelated
As this cycle suggests, several psychological and behavioral factors can impact as well as be impacted by chronic pain. Some of these factors include one's perception of pain, such as one’s beliefs around pain; individual personality characteristics, such as attachment style; cognitive processes and any associated cognitive distortions; self-efficacy and locus of control; gender, age, and culture; learned behavior and conditioned responses; and emotional reactions towards pain (Cosio, 2020). Promisingly, besides pharmaceutical and over-the-counter pain medications, other techniques can be used to reduce and manage chronic pain. For more information on the specific types of chronic pain and their impact on psychological well-being, stay tuned for future content in this pain series.
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References
American Institutes for Research. (2021). The pain cycle: How physical, emotional, and social circumstances make chronic pain worse. https://www.air.org/sites/default/files/Moving-From-Pain-to-Wellness.pdf
Dydyk, A. M., & Conermann, T. (2023). Chronic pain. StatPearls. Retrieved August 3, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK553030/
Mills, S. E. E., Nicolson, K. P., & Smith, B. H. (2019). Chronic pain: A review of its epidemiology and associated factors in population-based studies. British Journal of Anesthesiology, 123(2), e273-283. https://doi.org/10.1016/j.bja.2019.023
Cosio, D. (2020). The perseverance loop: The psychology of pain and factors in pain perception. Practical Pain Management, 20(1).
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