A high pain threshold and a high pain tolerance are phrases commonly used, but what do they really mean?
First of all, it is important that we understand what pain is.
Pain is when our brain responds to signals coming from our body and it comes to the conclusion that danger is present. Our body is constantly sending signals to our brain to alert it of its status. Our brain is smart and uses the current context combined with these signals to decide if there is a high risk of damage.
If with the context our brain decided we are not at risk, or it is not the greatest priority, we will not feel pain at this time.
A high pain threshold means we are not experiencing pain, despite pain signals being activated. This threshold changes as the context changes. Our body has to make a decision on what the biggest threat to us is.
You are playing competitive football and you really care about the result of this match. You are tackled but manage to get up and play the rest of the game without any problems.Later that evening you notice severe pain in your knee and you struggle to walk.
We can see here that actual damage occurred long before the pain was the priority. This is an example where during the match you were experiencing a high pain threshold.
Let’s take a step forward by 2 months and see how your pain threshold can be lowered. This is assuming your injury was fully rehabilitated.
You are playing football and are tackled again in a similar way to before which resulted in your knee injury.
You immediately experience severe knee pain like before and you have to stop playing. You immediately think of the final in 2 weeks and you are devastated you aren’t going to be able to play.
The next day you notice your pain has mostly resolved and you wonder how it can be, given it was so painful the day before and more painful than the first time you injured your knee which resulted in 6 sessions of physiotherapy.
This is an example of your pain system is dynamic and it is learning from a previous injury to protect you from further injury. The buffer between potential damage and actual damage has changed in this scenario, so from this we know pain is not an accurate measure of true tissue damage.
How do I know if my pain system is becoming over protective?
So, you are experiencing pain for longer than you might expect or at a higher intensity than you might expect in comparison to the severity of your injury. Perhaps you aren’t even sure how this injury occurred.
Since the pain started, rather than getting better, it has become more noticeable. Activities you once found comfortable are now sore.
You have noticed that your pain isn’t just where it used to be, it is now spreading to other areas. Sometimes you start to feel the same pain on the other side of your body.
Your pain is starting to impact more areas of your life.
You may notice you are becoming more irritable, forgetful, and you are struggling to concentrate, switch off, or get to sleep.
You are thinking about your pain more frequently and looking for answers.
You start to feel less optimistic that your pain will ever go away.
Your pain stops making sense to you.
Does this ring true to you?
If you are experiencing these feelings, it is understandably very stressful. There are hundreds of people selling quick fixes online, and unsurprisingly, the quick fix isn’t the answer. You need a skilled professional who understands pain mechanisms and who can make full sense of your experience.
Why might my pain system be overprotective?
There are many factors in your life unique to you that influence your body’s self-protection mechanisms and therefore pain.
A few examples include:
The threat of this injury on your ability to work and consequences of this.
A threat to your identity – for example if this injury doesn’t resolve you may have to withdraw from your hobbies or professional career as an athlete.
Knowing friends or family who have had serious repercussions due to a comparable injury.
Having a negative experience with a healthcare professional in trying to seek help.
Your lifestyle or career has no flexibility to allow you to modulate your activity around an injury to allow yourself to recover
You are worried this injury will lead to surgery or a scary diagnosis.
You are worried how those dependent on you will cope if you are injured.
You are genuinely worried that you won’t recover.
You are exhausted, you are struggling to fulfil your basic needs with enough sleep and nutrition.
How do I know if there is something serious causing my pain?
The most important thing to do is consult a health care professional who understands complex pain e.g. a physio or GP. There are many reasons for your pain becoming ongoing and this healthcare professional can rule out sinister causes, provide a diagnosis or explanation, and create a plan and guide you to the appropriate healthcare professional, imaging or specialist.
How do I recover from this persistent pain?
First of all you need to be ready to uncover what helpful and unhelpful mechanisms are affecting your pain and stopping you from recovering.
Your healthcare professional will make you feel safe. They will understand your pain, help you understand your pain and provide a treatment plan and most of all empower you to overcome this.
There is no “one size fits all”, as you can see, your pain experience is unique to you. Timelines go out of the window when pain becomes persistent. In general, the longer the pain has been with you, the longer it can take to overcome.
Your treatment plan should primarily consist of a joint discovery of your pain and protective mechanisms and how to overcome these. A tailored exercise program will be essential. Hands on treatment in some people can be very helpful, and you may need this to calm your pain system to be able to gain the benefit of the exercise.
Your health care professional may suggest you link in with your GP or a Pain Specialist Doctor for medication that may be essential in your recovery process.
Most importantly, you need to feel like you can trust your professional and feel they completely understand your experience and believe you will get better.
How can we help you at Melbourne Sports Physiotherapy?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!