You probably know the feeling: the back twinge that won't quite settle, the shoulder ache that lingers long after the injury should have healed, the ankle you rolled months ago that still isn't right. Pain is one of the most universal human experiences, and yet it's one of the most misunderstood. Most of us treat it as a simple signal that something is physically broken or damaged. The reality, as it turns out, is far more interesting.
Pain is often misunderstood as a purely physical experience, but that’s only part of the story. The International Association for The Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”.
Pain is a two-way communication between the receptors and the brain. When there is danger, our receptors, either through vision from our eyes or touch on our skin, detect it and send signals upwards through the spinal cord into the brain. The brain processes that danger, then sends signals back down to respond accordingly. These pathways are driven by several chemical and hormonal reactions, all in a matter of milliseconds.
So pain is essentially an experience driven by chemical changes in the body. Which means you don't always have to have physical damage to experience pain. And pain isn't necessarily negative, because it is the only way our bodies can communicate to protect us from danger.
Acute vs persistent (chronic) pain
Acute pain is short term, often a warning sign in response to disease or damage such as an injury, surgery or trauma. Inflammation is frequently involved, though not always, depending on the source. Acute inflammation should be expected to subside within a week.
Persistent pain, widely known as chronic pain, lasts more than three months. The body stays on high alert, consistently warning itself of danger even when there isn't any. This is when the nervous system becomes more involved than purely physiological bodily changes, something known as central sensitisation.
When to seek professional help
It's always reassuring to seek professional help when you have an injury, simply to ensure it isn't anything too serious. In my experience, ankle sprains are often overlooked, with help sought much further down the timeline when, ideally, it should be found earlier. I'd also suggest seeking help when pain persists despite several self-help attempts, because the pain pathology may otherwise worsen into something more persistent. Though there are a few things you can do at home to ease some symptoms.
Managing pain
Cold vs hot. Historically, we've defaulted to cold therapy, particularly for acute injuries such as an ankle sprain. But recent studies reveal that a warm compress appears to be more effective for muscular acute pain such as delayed onset muscle soreness (DOMS) and muscle spasms. For persistent pain, warm and cold compresses can both be effective, with no significant difference between the two. Crucially, we shouldn't reduce inflammation too soon, whether by applying a cold compress or taking anti-inflammatory drugs following an acute injury, as inflammation is a necessary part of soft tissue healing. Reducing it too early restricts blood flow to the injured area, which can delay recovery.
Painkillers and drugs. Painkillers such as over-the-counter paracetamol and anti-inflammatory drugs are commonly used to manage pain. Anti-inflammatory drugs work by reducing inflammation through a chemical reaction, while others, such as codeine-based drugs, act on the brain directly, either by sending "happiness signals" down the pathway or reducing "high alert signals" travelling up to the brain. Long-term painkiller use carries significant risks, addiction being the most widely feared, though others such as reduced bone density and organ damage can also occur, particularly with opioids.
Mindfulness and breathwork. Our mental health and emotions have a strong influence on our pain experience. Studies show that mindfulness and breathwork enhance the "happiness signals" travelling down the communication pathway, acting as a natural pain remedy.
Exercise. Movement is another natural remedy. Alongside those "happiness signals", exercise also brings physiological benefits, improving our bone and joint health. Recent trends such as run clubs, group Pilates sessions and social clubs are a positive shift for our society, because they involve not just movement but also connection. And social factors, too, influence our pain experience.
The takeaway
Pain is an experience influenced by biological, psychological and sociological factors. No two pains are the same, even with the same diagnosis, which is why treatment should always be individualised. Though getting to the root of it, and understanding where it comes from, could make all the difference in how you recover.
