Pain is a topic that crops up a lot in the clinic when rehabilitating clients back from an injury.
What is Pain?
Pain is an uncomfortable feeling in your body that warns you something is wrong. While this feeling is the body’s way of alerting your brain that there is a problem, it can go on for weeks, months, or longer.
Acute Pain and Chronic Pain
There are several ways to categorize pain. One is to separate it into acute pain and chronic pain. Acute pain typically comes on suddenly and has a limited duration. It’s frequently caused by damage to tissue such as bone, muscle, or organs, and the onset is often accompanied by anxiety or emotional distress.
Chronic pain lasts longer than acute pain and is generally somewhat resistant to medical treatment. It’s usually associated with a long-term illness, such as osteoarthritis. In some cases, such as with fibromyalgia, it’s one of the defining characteristic of the disease. Chronic pain can be the result of damaged tissue, but very often is due to nerve damage.
Both acute and chronic pain can be debilitating, and both can affect and be affected by a person’s state of mind. But the nature of chronic pain, the fact that it’s ongoing and in some cases, seems almost constant. This can make the person who has it more susceptible to psychological consequences such as depression and anxiety. At the same time, psychological distress can amplify the pain.
Muscle/Tissue Damage Pain
Most pain comes from tissue damage. The pain stems from an injury to the body’s tissues. The injury can be to bone, soft tissue, or organs. The injury to body tissue can come from a disease such as cancer. Or it can come from physical injury such as a cut or a broken bone.
The pain you experience may be an ache, a sharp stabbing, or a throbbing. It could come and go, or it could be constant. You may feel the pain worsen when you move or laugh. Sometimes, breathing deeply can intensify it.
Pain from tissue damage can be acute. For example, sports injuries like a sprained ankle or turf toe are often the result of damage to soft tissue. Or it can be chronic, such as arthritis or chronic headaches. And certain medical treatments, such as radiation for cancer, can also cause tissue damage that results in pain.
Nerve Damage Pain
Nerves function like electric cables transmitting signals, including pain signals, to and from the brain. Damage to nerves can interfere with the way those signals are transmitted and pain signals that are abnormal. For instance, you may feel a burning sensation even though no heat is being applied to the area that burns. The pain caused by nerve damage, neuropathic pain, is often described as burning or prickling. Some people describe it as an electrical shock. Others describe it as pins and needles or as a stabbing sensation. Some people with nerve damage are often hypersensitive to temperature and to touch. Just a light touch, such as the touch of a bed sheet, can set off the pain.
Pain during rehabilitation from injury
During your recovery from an injury your physio/sports rehabilitator will most probably prescribe exercises for you to perform to help with your recovery. These exercises can sometimes cause a bit of discomfort and pain as your body starts to adapt to the increase in load.
Pain is not always bad. For example, as you may ache and feel stiff after a heavy gym session, post exercise muscle soreness (DOMS) is usually associated with the satisfied feeling that you worked hard! This is a normal adaptation and sensation when regaining optimal muscle function post injury, when the structures involved have not been able to be used for a period of time.
So how do you know if you’re doing it right?
There are three things we like to consider when talking to our clients about preforming their exercises.
– Pain during activity
– Symptom response for 24 hours after activity
– The trend in symptoms over time
Broadly speaking when practitioners talk to their clients about pain, we create a pain scale. 0 being no pain at all and 10 being the worst pain you have ever felt. Then we ask our client to give their current pain a score between 0-10 during exercise.
Once we have discussed a pain score, we advise that when performing the prescribed exercises, they should not exceed a pain level of 5-6/10. We’d like to keep the pain levels minimal 0-3/10, although in some cases moderate amounts are acceptable 4/5-10. If any pain over 5-6/10 is experienced during the exercises, you should stop and seek advice from your practitioner.
If you experience any pain during performing your exercises, it is important to see those pain levels reduce back to baseline levels 0-3/10 within 24hours of exercising. If the pain continues for longer than 24 hours, you need to go back to your practitioner. They may need to adjust your exercises to better suit your injury.
It is key to note how you are feeling after each training session and how your injured area felt after each exercise (e.g. weak, swollen, hot, pain, discomfort, comfort, pain free). Your practitioner will be looking for trends within your symptoms. From this they can adapt your exercises to make sure they are correct for your stage of rehabilitation.
Here at Comfort Health
At Comfort Health, we have a great team of practitioners, all whom are able to help with injury rehabilitation and pain management. They are all equipped with the knowledge and experience to create an exercise program tailored to you helping you get back to full health.