Pain – how it arises, what it tells you, and what you should do with the signals
According to the Global Pain Index Report 2020, 93% of the nearly 20,000 respondents worldwide experience pain at least once a year. 34% experience pain daily. This is reason enough to take a closer look at the topic of “pain.”
Pain Unveiled: Unraveling Mechanisms, Tolerance, and Exercise
Pain, a universal human experience, is a complex phenomenon that transcends physical sensations. It intertwines with emotions, mental states, and individual tolerance thresholds. In this exploration, we delve into the intricate mechanisms of pain, unravel the mysteries behind varying pain tolerances, and contemplate the controversial question of whether one should train while in pain. Additionally, we discuss the crucial decision-making process of seeking professional help and when it might be time to consult a doctor or a physical therapist. By André Pedro.
Understanding the Mechanisms of Pain
Pain is a multifaceted phenomenon that involves intricate signaling processes within the nervous system. At its core, pain serves as a protective mechanism, alerting the body to potential harm or damage. The nervous system, comprising the central and peripheral components, plays a pivotal role in transmitting and interpreting pain signals.
Nociceptors and Transduction
Nociceptors are specialized sensory nerve endings located throughout the body, particularly in the skin, muscles, joints, and internal organs. These nociceptors are equipped with receptors that respond to specific types of stimuli associated with tissue damage or injury. When stimulated by noxious stimuli such as mechanical pressure, extreme temperatures, or chemicals released during inflammation, nociceptors undergo a process called transduction. During transduction, the energy from the noxious stimulus is converted into electrical signals, known as action potentials, which travel along nerve fibers towards the spinal cord.
Transmission
Once nociceptors have generated action potentials in response to noxious stimuli, these electrical signals are transmitted along nerve fibers, primarily via two types of nerve fibers: Aδ fibers and C fibers. Aδ fibers are myelinated and transmit sharp, well-localized pain signals rapidly, conveying the initial “sharp” or “prickling” pain sensation. In contrast, C fibers are unmyelinated and transmit slower, duller, and longer-lasting pain signals, contributing to the “burning,” “aching,” or “throbbing” quality of pain. These nerve fibers carry the pain signals from the peripheral tissues to the dorsal horn of the spinal cord.
Modulation in the Spinal Cord
Within the dorsal horn of the spinal cord, pain signals undergo modulation by various neurotransmitters and neuromodulators. Excitatory neurotransmitters such as glutamate facilitate the transmission of pain signals to ascending pathways leading to the brain. Conversely, inhibitory neurotransmitters such as gamma-aminobutyric acid (GABA) and glycine help dampen or inhibit pain signals, exerting a modulatory effect on pain transmission. This modulation can occur through complex interactions between different types of neurons and synaptic connections within the spinal cord.
Projection to the Brain and Perception
After modulation in the spinal cord, pain signals are relayed to various regions of the brain, including the thalamus, somatosensory cortex, and limbic system. The thalamus serves as a relay station, directing pain signals to the appropriate cortical areas for processing. The somatosensory cortex interprets the location, intensity, and quality of pain sensations, while the limbic system, which is involved in emotions and memory, contributes to the emotional and affective aspects of pain perception.
By understanding these detailed processes involved in pain signaling—from nociceptor activation to transmission, modulation, and perception—we gain insight into the complexity of pain and the potential targets for pain management and treatment. This multifaceted understanding is crucial for developing effective interventions to alleviate pain and improve the quality of life for individuals experiencing pain-related conditions.
Individual Differences in Pain Tolerance
Despite the commonality of pain, individuals exhibit marked differences in their ability to tolerate it. Genetic, psychological, and environmental factors all contribute to these variations in pain perception. Genetic predispositions influence an individual’s pain threshold, determining how sensitive their nociceptors are to stimuli.
Psychological factors, such as anxiety, depression, and stress, can amplify or diminish the perception of pain. Moreover, past experiences and cultural influences shape one’s response to pain, further contributing to the diversity in pain tolerance among individuals.
Training Through the Pain: Wise or Foolish?
The age-old question of whether one should train while in pain sparks heated debates within the fitness and medical communities. The answer, it appears, is not black and white but rather dependent on the nature and severity of the pain.
In some cases, mild discomfort during exercise can be attributed to the normal physiological responses associated with physical exertion. Muscles adapting to new activities may experience temporary soreness, commonly known as delayed onset muscle soreness (DOMS).
DOMS is a common phenomenon experienced by individuals after engaging in strenuous physical activity or exercise. It typically manifests as muscle pain and stiffness, usually peaking within 24 to 72 hours post-exercise. DOMS occurs as a result of microscopic damage to muscle fibers, particularly during eccentric contractions, where the muscle lengthens while under tension. This damage triggers an inflammatory response in the body as it works to repair and rebuild the affected muscles, leading to soreness and discomfort. While DOMS can be uncomfortable, it is generally considered a normal and temporary side effect of physical activity, especially when introducing new exercises or increasing intensity.
Despite its name, DOMS isn’t always delayed, sometimes setting in immediately after or during exercise, particularly in cases of intense or unfamiliar activities. Although it may be tempting to avoid physical activity due to DOMS, staying active with gentle movements or low-impact exercises can actually help alleviate symptoms by promoting blood flow and aiding in the recovery process. The most effective strategies to overcome DOMS you can find in this blog post (GERMAN).
While it’s important to listen to your body and avoid overexertion, experiencing DOMS occasionally is a sign that your muscles are adapting and becoming stronger. With consistent training and a well-rounded approach to recovery, individuals can minimize the impact of DOMS and continue to progress towards their fitness goals.
“What about stretching? I heard it helps reduce the pain!!!”
In the pursuit of optimal post-workout recovery, it’s essential to reevaluate traditional practices like stretching. While stretching has long been hailed as a necessary component of a cool-down routine, recent research challenges its immediate benefits. Studies suggest that static stretching directly after exercise might not significantly reduce muscle soreness or enhance recovery compared to alternative interventions like light aerobic activity or foam rolling. Moreover, static stretching could potentially compromise muscle strength and power when performed on fatigued muscles, potentially hindering performance in subsequent activities requiring explosive movements. Read here what stretching can do for you and what not.
Currently, it’s advisable to steer clear of evidence-based suggestions regarding the utility of post-exercise stretching for recovery purposes, given the inadequacy of available data to substantiate associated assertions. Therefore, the decision to stretch post-workout should be approached with caution, considering individual preferences, goals, and the demands of the exercise routine. Balancing the latest scientific findings with personal experience and listening to the body’s cues is key to optimizing recovery and performance in fitness endeavors.
However, caution is paramount when dealing with persistent or acute pain. Training through severe pain may exacerbate underlying issues, potentially leading to long-term damage. Understanding the source and nature of the pain is crucial: joint pain, sharp stabbing sensations, or pain that worsens during exercise should never be ignored.
When to Consult a Professional: Doctor vs. Physical Therapist
While some pains may be self-limiting and can be managed with rest and proper care, others necessitate professional intervention. Deciding between consulting a doctor or a physical therapist (PT) requires a thoughtful consideration of the symptoms and their impact on daily life.
When to See a Doctor
Sudden, severe pain: If the pain is intense and has a sudden onset, especially after an injury, seeking immediate medical attention is crucial.
Persistent pain: Chronic pain lasting for more than a few weeks or pain that progressively worsens requires medical evaluation.
Numbness or tingling: Any sensation of numbness or tingling accompanying the pain may indicate nerve involvement, necessitating a doctor’s assessment.
When to See a Physical Therapist
Rehabilitation needs: If the pain is related to a musculoskeletal issue or injury, a physical therapist can provide targeted exercises and therapies to promote healing. Trigger point therapy or dry needling are among the most effective strategies to overcome pain and can be booked directly with our personalworkout physio team.
Functional limitations: When pain hinders daily activities or limits range of motion, a physical therapist can design a personalized rehabilitation plan.
Preventive care: Athletes or individuals engaging in regular physical activity may benefit from consulting a physical therapist for preventive strategies and biomechanical assessments.
CONCLUSION
Pain, with its intricate mechanisms and individual variations, is a constant companion in the human experience. While navigating pain can be challenging, understanding its origins, respecting the body’s warning signals, and making informed decisions about training are crucial steps toward overall well-being.
Whether to train through pain requires a nuanced approach, considering the type and severity of the pain. While mild discomfort may be manageable with prudent exercise, severe or persistent pain demands professional attention. Knowing when to consult a doctor or a physical therapist empowers individuals to take charge of their health, fostering a holistic approach to pain management and rehabilitation. Remember, pain is a messenger, and deciphering its signals with care can pave the way to a healthier, pain-tolerant, and resilient self.
SOURCES
- https://www.health.harvard.edu/topics/pain
- https://europeanpainfederation.eu/what-is-pain/
- https://pubmed.ncbi.nlm.nih.gov/30586067/
- https://pubmed.ncbi.nlm.nih.gov/26088531/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814802/
- https://journals.physiology.org/doi/full/10.1152/jn.00457.2012?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
- https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2021.677581/full?fbclid=IwAR2k3FE6ZUwkrPc6clrbBBgbUkMjQuia1_Re81qUNh4u-XMA2AaAyHzJcN4%2F%3Famp%3D1
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831894/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091428/
- https://www.mdpi.com/1648-9144/58/10/1332
Challenge of the Month
What Clients Say
What You Get
