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Wednesday, March 22, 2023

Five Misconceptions About Chronic Pain

Back, neck, head, shoulder…: Pain is a common experience that can appear anywhere on the body. According to the Spanish Association of Health Directors, between 40 and 80% of medical consultations are related to pain, and it is estimated that 17% of the Spanish population suffers from chronic pain, which occurs when episodes of pain occur for at least three months .

What role does the brain play in this pain experience that persists over time? As Rubén Nieto, psychologist specializing in persistent pain and professor at the Department of Psychology and Educational Sciences at the Universidad Uberta de Catalunya (UOC) explains, “pain is a subjective experience that forms the brain from the interaction of multiple factors, and psychological factors play a very important role among them.” Therefore, commonly held beliefs that chronic or persistent pain may not be real are often widespread.

Here are some misconceptions about pain:

If no physical cause is found, the person compensates for the pain.

The fact that, sometimes, not finding an easily identifiable cause for the pain that a person is feeling can lead to the belief that he is compensating for his pain. However, as psychologists Ruben Nieto and Maite Sirat, authors of Pain and Psychology, point out: Why is a pain specialist necessary? Pain is always real and is generated regardless of what the person may be thinking or thinking.

Traditionally, pain is understood “from a biomedical model associated with tissue damage, interpreting that the greater the damage (greater the pain), the more pain is felt. Thanks to neuroscience, we know that this is not the case”, says Sirat , using as an example the phantom limb, which happens when a person feels pain in a part of the body that no longer suffers. “It’s possible to feel pain without a physical body and it’s just as real as if you had that physical part. You have to keep in mind that pain is neither necessary nor sufficient to generate pain”, emphasizes the psychiatrist and physiotherapist.

The Pain is Physical or Psychological.

According to experts, pain is an opinion of the brain that is not directly related to the amount of physical damage it can suffer, but to “how much” of threat or danger that the brain interprets as potential or real damage that it can generate. But, as Robin Netto explains, the polarization of pain as physical or psychological does not make sense “to the point that the experience of pain is unique and constructed exclusively for each person, based on the interaction of multiple factors. an important weight in the experience of pain, which does not mean that pain can be classified as exclusively psychological.

Among the psychological factors that modulate the perception of pain is mood, which can influence the way pain is experienced. “If we feel sad, for example, we tend to see things more negatively and they affect us more. In this sense, what we call catastrophic thoughts can arise, which consist of seeing the situation (the pain) as something we can do nothing about, occupying a large part of our thoughts, and as something terrible, much more than we can imagine. 🇧🇷 really is. Thinking this way can also make us afraid of hurting ourselves or doing activities that might increase the pain, creating a vicious cycle that can end up making us feel worse, ”says the University of Oklahoma professor. In the same way, stress can also affect him, as It leads to an increase in pain or “excites” pain in him, while the feeling of pain can lead to stress.

Nothing Can be Done to Help Ease the Pain

As Neto and Sirat point out, feeling pain when a body part is in danger is not only normal, but also desirable. But when it fails to fulfill this function of survival and protection, it fails to fulfill its mission. In these cases, the action of the person who feels the pain is fundamental.

“Pain does not necessarily mean that there is tissue damage, but that the brain has learned to associate certain sensations and perceptions with pain. It is about teaching the brain to resignify and re-educate these relationships. This reconceptualization can be done through education in the neuroscience of pain, and explaining the mechanisms by which associations occur. And through different techniques and exercises, as Mait Sirat points out.

Thus, if the brain interprets that even if there is real damage, it is not necessary for the person to take a specific action, it will not generate pain, as happens when someone discovers a bruise and does not even remember where and when they were injured. “Realizing that the experience of pain is part of the learning process, it can be unlearned to receive a proper education and for the brain to create new association concepts that allow us to generate functional pain for our survival and eliminate persistent pain that is no longer compatible with your task”, explains the psychologist.

Chronic or Persistent
Pain is a Woman’s Thing

Some diseases such as fibromyalgia are mainly associated with females, and this reality may lead one to believe that chronic or persistent pain is an experience that only women suffer. However, according to Robin Nieto and Maet Sirat, there is a problem of underdiagnosis of diseases such as fibromyalgia in males “perhaps due to social stigmas due to the very feminine character of the disease and the stereotyped image of male strength in the face of pain, making it clear that it is necessary and urgent to apply a gender perspective in all domains, and the context of pain is no exception.

The Environment of a Person with Chronic or Persistent Pain Cannot do Anything to Help.

According to psychologists, people in the environment can, through their behavior, influence the factors involved in modulating the patient’s pain. That’s why their role is also important. “If, for example, when the person in pain shows his problem, someone around him does all his activities, and always does it, certainly, unintentionally, this will make that when the person in pain wants to do the activities again, she has more difficulties. Neetu and Sirat point out that avoidance is not a good strategy, confrontation is necessary. Thus, it is important to involve family members in treatments so that people in pain can effectively cope with the necessary help. Messages and indications are also of great importance, so a proper understanding of the function and factors that go into pain classification is essential.

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