Video Editor: Shubham Khurana
(The Article is part of FIT's #DecodingPain series, where we pull apart the many layers of pain–the sensation, the causes, the stigma, and the treatments.)
This is what happens to your body when you get hurt:
Tiny neurotransmitters in your nerves at the site of the injury send signals through your spinal cord, to your brain. Here, the signals are processed.
Depending on its assessment, the brain then responds with its own signals, sending a rush of blood flow to the area with a bunch of chemicals, and mobilising your immune system to start patching it up.
All of this happens in a matter of seconds.
Injury results in pain. This is the most straightforward explanation of pain.
But what is happening to your body when you're in pain and there is no injury?
FIT Speaks to Dr Dhruv Bibra, Pain management specialist at Delhi Pain Management Centre, who breaks down pain and the many ways in which it can manifest.
"Just imagine that you might be wearing a watch. So, tomorrow if you forget to wear a watch, when you are not even wearing a watch, you will get a feeling that something is missing, right?"Dr Dhruv Bibra, Pain management specialist at Delhi Pain Management Centre
"So, what has happened is there is a circuitry which has been formed from that stimulus in your brain, and without that stimulus, your brain continues to feel that pain," he explains.
Pain can be classified into three broad categories: nociceptive, neuropathic, and dysfunctional pain.
He explains, "Nociceptive pain is your common injury-related pain. Then you have the dysfunctional pain."
Neuropathic pain on the other hand, is a pain which is caused by a disease or a lesion. So, basically there is a systemic disease which starts affecting the nerves which manifest as pain.
"Dysfunctional pain is slightly more technical, more challenging. It is because nothing is wrong, but your receptors are still firing," he adds.
Why Neuropathic Pain Is So Challenging
Along with being a chronic condition, neuropathic pain can also be difficult to cope with given the different ways in which it manifests.
"Now classically neuropathic pain is not only pain but will also have some sensory symptoms You can have numbness, tingling, pinpricks, needle pricks, and crawling all over your body."Dr Dhruv Bibra
He also speaks of how sometimes, in neuropathic pain, one may have conditions called hyperalgesia and allodynia.
"Hyperalgesia is where a small pain manifesting as greater pain. For example, if I do a pinprick, and you feel that somebody has stabbed you, so that is an exaggerated response to a painful stimulus," he says.
"Allodynia is a non-painful stimulus causing pain. For example, if I just touch you, you have pain as if you are burning, so that is allodynia."
Pain and Mental Health: How One Affects the Other
In a previous article, FIT explored how mental stress and trauma can lead to the development of chronic pain.
"When we talk about pain which has been there for a very long time, then definitely these emotional experiences have to be taken into consideration and they become a significant factor."Dr Dhruv Bibra, Pain management specialist at Delhi Pain Management Centre
Here, Dr Bibra explains how pain affects a person's mental state.
"Imagine, if somebody is having this pain for years together and is constantly living with the fear that whenever they indulge in any activity, that pain might come back. What we have seen with our patients is that there is a certain level of anxiety and hopelessness that comes with chronic pain," he says.
Dr Bibra also adds that patients who have chronic pain for years are often caught in this vicious cycle of where pain affects their mood and mood affects their pain.
Killing Pain: Treatment Options
In the case of chronic pain, especially neuropathic pain, Dr Bibra speaks of how treatments will have to begin by identifying the root cause.
Furthermore, when the pain is complex, the treatment will have to be multifaceted too.
Sometimes painkillers may not work. If no apparent physical cause is noted, one might have to look at psychological causes.
Dr Bibra talks about how combining different therapies can help.
"There are simple interventions like cognitive behavioural therapies like mindfulness which can be combined with (medication) to bring about a positive change in the patients. And not only treat pain, but also bring about a functional change in the day to day life of the patient."
(Want answers to your painful woes? Send in your questions to firstname.lastname@example.org, and we will get pain experts to answer them for you.)