Tissue damage, or nociceptive detection is always triggered the same way, but it’s the way the nociceptive inputs are interpreted that determines the extent of pain. With injury, pain usually starts to decrease as the tissues associated with the injury heal, and noxious inputs into the central nervous system decrease (Voscopoulos & Lema, 2010). For some the acute phase doesn’t end and there is a propagation of their pain into persistent pain. Psychosocial factors, more than physical factors, are the reasons for going on to develop chronic pain (Gatchel, Polatin, & Mayer, 1995) Pain is a combination of somatic input, psychological processes and environmental factors (Turk & Okifuji, 2002). These psychological and environmental factors can be further broken down into cognitive, affective, behavioural, social and cultural (Vranceanu et al., 2009).
Below is a break down of the things that may influence your pain. Have you ever wondered why after a stressful event your pain plays up? Or why if you have someone who has had the same type of pain your injury sometimes behaves in the same way? These factors below could play a huge part in your perception of pain.
|Psychosocial Aspect||Type of influence|
|Cognitive||· Thought processes surrounding the input – normal vs abnormal – is the sensation your feeling normal for you or does it threaten your wellbeing|
· Your expectations of how the pain should behave
· Are you an active or a passive coper?
· Self-efficacy – do you have motivation?
· Past Experiences individually, family or friends – have your friends or family had similar injuries with poor outcomes?
· Pain anxiety
· Heightened concern about anger
|Behavioural||· Avoidance – avoidance of activity or exercise|
· Re-enforced behaviour for a positive outcome by family, friends or medical professional – does your family or friends give you positive feedback or help when you are injured? Does that keep you acting injured for longer?
|Social and Cultural Factors||· Thought processes re-enforced by cultural norms – What is normal pain behaviour for you? Should you pull a face? Does this give you positive re-inforcement?|
· Ethnic differences in response to pain – does your culture and family have ways they treat pain that is different because of your background?
· Family interaction with pain response – does your family give you positive feedback with your pain – response like ‘ohh poor you? Would you like me to help?’ may influence the length of time you experience pain
· Dr Google – did Dr Google tell you you should be worried?
· Workplaces – do you get light duties or sympathy because of your pain?
· Home – does it mean you don’t have to do as much around the house? Do you get let off on some duties?
· Socioeconomic – are you receiving benefits because of your pain? Does that make your pain seem worse?
Information gained from Vranceanu et al. (2009) & Blyth, Macfarlane, and Nicholas (2007).
All of these aspects above can influence the pain that you feel – but they also can be addressed and once aware that this may be having an impact on your pain can assist with decreasing your pain. The biggest aspect of pain is making sure that you understand why its happening – because without the why, why should you make changes? Why are they going to help?
Pain is complex, pain is annoying, but pain is also something that can be helped and little steps can make big differences!