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Why is it so hard to explain my pain, and who can help me?

Hey there, time traveller!
This article was published 09/12/2021 (1437 days ago), so information in it may no longer be current.

Pain is something many of us are all too familiar with. For some, it comes after suffering an injury during a sporting event or being involved in a motor vehicle accident. For others, it’s as simple as closing a door on our finger. Sometimes it just seems to appear for no good reason. Very often we know someone who has suffered an identical injury, but for some reason their experience of pain is vastly different than our own. How is it possible there can be such a difference in one person’s experience of pain compared to another with the same injury?

Pain currently is defined as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (as defined by the International Association for the Study of Pain or IASP). This just means that pain is influenced by many factors. Some are more biological in nature, such as pain that arises from inflammation after an acute ankle sprain. Other factors may be psychological, such as our beliefs on the cause of our pain or the emotions we experienced during or as a result of an injury. Social factors are also important, such as the effect on one’s abilities to work. Patient’s past experiences will have a significant impact on how one perceives pain and can explain why 100 people with the same injury will provide 100 slightly different descriptions of their pain.

Deciphering the language of a patient’s pain can be difficult, however, physiotherapists are well equipped to translate. Physiotherapists are much like a detective who must solve an unexplained mystery. Perhaps you could call us “detectives of pain”. Like a detective talking to a key witness about what they know to help solve the crime, we must interview our patient to help solve their pain. Our ability to ask the right questions and listen to our patient’s story is one of a physiotherapist’s greatest tools to help solve this mystery.

During the first physiotherapy session, patients may feel they are on “the hot seat”. They will be asked a great number of questions to help better find the right “clues” and solve the mystery of their pain. Common questions a patient may be asked include determining the what, where, when, and why. All of these questions help a physiotherapist better understand the nature of a patient’s pain.

Some questions may even seem somewhat out of place, but to your physiotherapist they are important. For example, someone who was involved in a motor vehicle accident may be asked about their feelings regarding the experience during or after the accident. Some may state they were quite fearful of being severely injured as the impact of the car accident was quite significant, while others may suggest it was mild as they have been involved in worse accidents before.  Some may have been required to attend a hospital for imaging to rule out significant injuries. This can be comforting for some, while for others, the requirement of imaging at a hospital could be overwhelming and add to the experience of pain.

Other questions may pertain to how you feel about returning to work after suffering an injury while on the job. Many may be relieved to return to work as they can begin to provide for their family again, while others may feel worried that a return to work could result in reaggravation of their pain.

These are only a few examples of questions you may be asked during your first session with a physiotherapist, but they can all be crucial in determining the root cause of one’s pain and moving people towards recovery. These questions not only help physiotherapists determine what may be contributing to a patient’s pain but will also help a physiotherapist individualize a patient’s rehabilitation program.

Understanding a patient’s thoughts and beliefs not only towards the cause of their pain, but also how to fix it can be a powerful tool in our quest to help resolve pain. Physiotherapists can provide a number of various treatment approaches to help manage a patient’s injuries and resulting pain experience. These include manual techniques, exercise therapy, electrophysical agents, ultrasound, and acupuncture to name a few. Patients who have experienced a positive outcome with one form of treatment, or who perhaps believe a certain form a treatment may be beneficial based on a trusted friend’s advice, can greatly improve the likelihood of a positive impact on their pain/symptoms compared to a treatment they may be hesitant to try.

So, when you attend a physiotherapist for an initial assessment to help with your pain/injuries, be ready for some questions. Hearing your story can be the greatest key to helping a physiotherapist solving the mystery of your pain, which is why we spend the time listening.

Craig Marchylo is a physiotherapist at Riverbend Physiotherapy & Sports Injury Centre. You can find Craig and many other great physiotherapists in the “Find a Physiotherapist” section of our website at www.mbphysio.org. 

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