Pain

Have you ever felt a sensation that resembled the sensation of pain in every way except that it wasn't annoying? This has occurred to me with toothaches more than once. Particularly when the sensation first begins, I might recognize it and realize that it's a toothache but that it was not an irritable sensation. It's difficult, if not impossible, to put the sensation of pain into words that would be descriptive to anyone not experiencing it.

At such times, I have considered the sensation that we call pain and wondered why we are so annoyed with it. Why could we not consider that same sensation to be pleasant?

As the sensation continues, however, eventually it gets to the point where it becomes annoying. But, while I couldn't put it into words, I can't even develop a mental picture of the sensation before it began to annoy me that would be significantly different than the one that I would describe as pain.

This is even true of throbbing pain. For a time, at least, I can experience a throbbing sensation as if it were pleasant. It is only when it continues for a period of time, unabated, that it becomes annoying.

On a related subject, do you have any pains that you have become accustomed to? While I don't consider myself to be old yet, I have some pains that have been with me for years now. At first, I would make that complaint to my doctor but, as my doctors concentrate on things like whether or not I should be taking statin drugs, nothing was ever done about the pains. Months later, my doctor might notice that I had made a previous complaint about pain and ask me about it. My first thought would be that no, I don't have any pain. Then I would realize that yes, I do still have that pain, but I have gotten used to it and no longer recognized it as such.

Although we all know it when we feel it, there is no precise definition of pain. Not everyone experiences it in the same way.

As a paramedic, one of the assessments that we were supposed to make of people complaining of pain was to ask them to rate their pain on a scale of one to ten, and I always considered that to be an all but useless assessment because we all have different tolerances to pain. Some patients would be screaming in pain over the same injury that another patient wouldn't even mention unless I asked about it, and that wouldn't mean that the first patient's injuries were more serious. One patient might describe the pain associated with an injury as a 10 while another patient, with the same injury, would describe it as a 2.

Women in the United States seemingly experience more pain in childbirth than do women in Africa. While there may be some physical reasons for this, the difference is largely cultural. In the United States, women are permitted to feel more pain, and consequently, they do. People from cultures that value stoicism experience less physical suffering than do those from cultures that permit a greater expression of emotion.

That's what the studies indicate, but do they? Are people from the more stoic cultures simply not expressing the same amount of pain that others might scream about?

There seems to be a strong psychological ingredient in a person's perception of pain. That is, at least, what I can see in myself. For a time, at least, I can persuade myself that pain is tolerable or even pleasant, although I am quite free to act like a baby if I want to. In cultures where people do not feel so free to express their pain, are they suppressing it or are they simply not experiencing it as strongly as others might?

When I worked for Champion Bag Company, we had an employee who was from South Vietnam. One might think that the Vietnamese would be a stoic people but he would react to even the slightest of injuries as if he were on the verge of dying. If he broke a nail, his screams could be heard from across a room full of very noisy bag machines.

On the other hand, some people seem to barely feel pain at all. Working in the woods with my father, I could barely concentrate on my work sometimes because I was being attacked by mosquitoes, black flies, deer flies, horseflies, and all manner of insects. Dad would say, "Ignore them and they'll leave you alone."

Well, there might have been some truth in it but they weren't leaving him alone. He had welts on his arms too, but he didn't seem to notice them. Because he didn't scratch at them, they went away more quickly.

I do know that when I have been very busy working, I would be far less likely to notice that I had hurt myself until I had time to think about it.

I forget the name for it, but there are some people who feel no pain at all, and they live in danger because they are lacking the warning signs that pain often gives us, such as if we are resting our elbow on a hot burner or stepping on a nail.

The sensation of pain is often divided into acute and chronic pain, although neurologists have more than a hundred classifications for pain.

Acute pain is like the alarm clock going off, letting us know that we have cut a finger or a leg, or perhaps that we are having a heart attack. Acute pain can be expected to go away eventually.

Chronic pain endures. People with chronic back pain are one of the most common reasons for people seeing doctors, followed by those with chronic headaches.

Despite evidence that some pain is psychological in origin, doctors are encouraged to treat all aches as real, because they are real to the people who are experiencing them. Entire clinics and medical specialties are devoted to pain management, and laws have been passed entitling every patient to effective pain management.

One of the most common means of managing pain is through drugs, and this has led to new classifications of drug abusers.

 

Good points, @Don Alaska. Perhaps the only usefulness to pain assessments is in measuring changes in pain. A patient who tells me that his pain is a 4 upon first assessment, and later assigns it an 8 might be worth noting.