Video script: factors that affect pain
GGC - 12 Week Pain Management Programme
This content is designed for the participants of the GGC Pain Management Programme.
1. In this presentation we are going to discuss a number of things that we know can influence the pain that we experience as well as how we deal with our pain.
2. In some of the other videos, we have talked about how our nervous system is always working as a protective system and is constantly trying to work out how much danger we may be in.
It uses a wide range of information to help it answer the question ‘am I safe or am I in danger’?
This image shows us a number of things that we know help our nervous system uses to help it answer that question.
- The sensations we are experiencing
- Our previous experiences – what happened when we have been in this situation before.
- Our thoughts and feelings at that time – some we may be aware of and other we may be less aware of.
- Family/work/environment – we all juggle different roles and responsibilities in life – how might those affect our pain and how might our pain affect our ability to fulfil those roles and responsibilities.
- Conflicting information from health professionals
- Knowledge of our condition/our pain
We will talk about each of these influences in turn.
3. How can our previous experience influence our pain?
In order for our nervous system to work quickly to protect us, it is constantly trying to predict what might happen to us and it does this by continually learning from our experiences
A great example of this is the snake bite story by Lorimer Mosley. You can watch this story by clicking on the separate link. This true life story demonstrates how our nervous system tries to work out if we are safe or not and how it can reach the wrong conclusion.
4. We also know that as well as our previous experiences, our thoughts and feelings can influence our pain and our pain can very much influence our thoughts and feelings.
Have you noticed that when you experience an increase in your pain, that you may feel more anxious, worried, or even depressed?
On the flip side, on days when your pain is less, you may feel more sociable and happier.
You may also have noticed that when your mood is better that your pain takes up less of your attention. Or, when you are worried or anxious that you may notice an increase in your pain.
This is because we do not have distinct areas in our brain that deal with pain and mood. Instead, the same areas in our brain are active when we experience pain and also negative emotions. This can mean that pain and mood can feel like extra fuel on the fire for each other.
We will talk more about our thoughts and feelings in the coming weeks.
5. Whats our environment got to do with our pain? If you think about an environment where you feel safe, comfortable and you are in control, that may be your home, garden or a favourite place. If you compare that to how you would feel about going down Sauchiehall Street on a busy Saturday afternoon where you are being bumped and jostled by the crowd. How do think you would feel in those two very different situations? Our environment around us can have a significant effect on how safe we feel and as a result, on our fight and flight system. We will explore this further later on.
6. Conflicting information is another factor that can influence our pain. If you think about all the different appointments that you have had over the years. Perhaps the various health professionals that you have seen have used lots of different terms to explain your pain and this can lead to confusion as it can often feel as if they are saying different things. Unfortunately, medical terminology can often be confusing and this can mean it is difficult to make sense of the information that you are given. This can mean that people often don’t understand why they still have pain, and importantly, what they can do in order to manage it and live well with their pain.
7. Knowledge is power. When we think about our knowledge, we often attach this to having a diagnosis in order to be able to make sense of our situation. Within Scotland, chronic pain is recognised as a condition in its own right. This is known as primary chronic pain. Pain is the condition rather than the pain being a symptom of something else. By learning about the changes that take place in our nervous system when we have had pain beyond 3-6 months, we can learn how to take steps and develop strategies to allow us to live well with our pain.
8. I mentioned our fight and flight response earlier. This is a chain of responses that takes place in our body when our nervous system perceives that we are in danger. Remember, that it doesn’t have to be actual danger, our nervous system just needs to think that there is the potential for danger. You might have noticed lots of different sensations in your body when your experiencing stress. Think about how you felt before your driving test or perhaps giving a speech at an event or maybe going somewhere new and unfamiliar. All of these sensations are because our nervous system is getting us primed for action – to fight our corner or run from danger.
9. What we find is that our muscle tension increases. Our heart rate also increases and you might notice that you feel on edge. Our thoughts can feel jumpy and it can be difficult to focus on different things. Our sleep can be affected as are ready for action, not for rest. How do you think you would feel if that went on for a long time? It would feel exhausting. When we experience chronic pain, this causes our bodies and nervous system to experience a degree of fight and flight all the time. This might help you make sense of some of the things that you experience alongside your pain.
10. When we think about the factors that influence our pain, I think about it as a flame. Ideally, it would feel like a gas hob and something that you have some degree of control over but often it can feel like a forest fire, raging out of control. As you can more understanding of the things that influence your pain, you can learn and develop strategies in order to help you live well with your pain.