Pain and injury are not the same

There is a straightforward difference between pain and injury. Pain is subjective and injury is objective. Pain is a lived experienced. An injury is a disruption of the body tissues. You cannot see pain. Usually, you can see an injury.

Unfortunately the words are often used interchangeably. Further, there is the belief that pain and injury are well related. However, we have known that this is not the case for many years. Pat Wall, one of the forefathers of modern pain medicine and science, spoke about this in his famous 1979 lecture. Since then there have been countless studies showing that pain is part of how we protect ourselves and related to the state of the person within a particular context.

We have many stories of varied pain responses to different injuries. Sports people continuing to play with sprains and fractures, soldiers sustaining severe physical trauma reporting no pain, and the large proportion of people suffering the symptoms of IBS without any notable pathology. More-so, there are no investigations that show pain. Pain cannot be seen on an X-ray or an MRI scan.

We must be clear. People suffering pain must understand why they feel pain, why and how it can persist, and then focus on the steps that they can actively take to move on and get better. Misunderstanding pain is one of the main stumbling blocks. Erroneous thinking results in wrong decisions about treatment and self-care, but also impacts upon the sense of empowerment, belief in oneself to improve and hope.

Truly understanding pain helps the person to let go of unhelpful and fearful thoughts and to build confidence (in moving for example). It creates a strong foundation from where the person can build and gather momentum towards their picture of success.

RS