What is pain?
Also Known as Nociceptive pain
Pain can be a complex topic and there are different types and mechanisms that cause pain. It can be experienced over a short period, acute or longer term over months is classified as more persistent pain. In this article we focus on a common pain caused by a specific acute sports injury. We strongly recommend speaking to a professional if you are experiencing pain and they will be able to quickly diagnose the type of pain you are experiencing and how to reduce this to get back to your normal activities.
Pain caused an injury and by inflammation itself is generated by the pain sensitive nerves and interpreted in the brain. When we have a sporting injury, slip, strain, sprain or bone break, nerve endings around the area are stimulated by mechanical stress to the tissues during the injury and an inflammatory chemical release from the damaged structures to notify the brain and to aid protection from any further injury. The pain sensitive nerves are often stimulated by more than one affected structure, this can be muscle, ligaments, fasca, bursa, bone or nerve tissues. This can last moments, days or weeks depending on the severity of the injury while the body is healing. Pain can be perceived in different sensations, such as, sharp, ache, throbbing, stabbing and can be constant or come and go on certain movements.
Pain intensity is also very individual and can be intensified by stress and anticipation and can be difficult to measure. As Physiotherapists we often ask ‘on a scale of 1-10 (10 being the highest) How painful is it for you?’ This allows us to gauge roughly the perceived intensity that an individual is feeling at the time and this can vary. The number will be related to your own individual scale and pain experience, as this can change at different times and be affected by many other factors in the day depending on the cause and can lead the therapist to the structures affected and then we can plan to reduce the pain sensation significantly over the course of treatment.
Compensation movements
Your therapist will look out for any compensation movements your body makes to avoid using the injured area. This is a useful body survival system in the first stages of injury but it’s not something we want to keep longer term as this can slow down the recovery of the injured area if it is rested too much.The joints and muscles can get stiff and weak if not used over a longer period of time. The injured area will need to move and get stronger under the guidance of a professional to get you back to and better than before the injury. The longer the injury is present for, the body can start to compensate for this injury to protect the area which causes altered movement patterns to become habit in other parts of the limb and body. As every body part is linked to the next up and down the movement chain you may get stresses on other structures away from the initial injury which then release pain chemicals and cause pain away from the original injury. The pain is then a combination of the injury and stress in other areas of the body in the muscle, joint and or nerves as the compensate for the original injury while it is healing.
Early rehabilitation can really help speed up the recovery times and avoid persistent compensations long after the initial injury has healed. Therefore reducing the time away from sports and reducing the amount of strength, flexibility, balance and coordination lost while recovering.
Referred pain
Some injuries have an obvious cause, some may require scanning to diagnose the specific level of damage to the tissues to aid treatment or some pains can be referred from one body part to another, called referred pain. You may hear this term from your Physiotherapist and therapists are trained to assess and accurately diagnose where the pain is coming from and the overall cause to prevent it coming back. This type of pain can be perceived as coming from somewhere away from the actual area of injury. An example may be lower back pain can refer to the bottom and down the leg but the source of the pain and main area for treatment will be in the back itself. It is important to note sometimes there will be local neural tension or a muscle response in the leg secondary to the back issue but the back is the main cause that will need the treatment to resolve the symptoms fully. By treating and being aware of referred pain we can make sure all aspects are treated to insure a speedy recovery.
There are other more complex pain syndromes which are not discussed in this article.
We advise to always be assessed by a professional GP or physiotherapist to determine the type and stage of an injury and the cause of the pain to ensure correct diagnosis and treatment to significantly reduce injury time and get you back to the activities you love.
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