Neuropathic Pain and Acute Pain Are Always In the Head

                               "The Pain Is In Your Head"


    What a ridiculous and non caring statement to make to a chronic pain patient.  Not only that but also a very pedantic statement totally lacking understanding of how pain is transmitted in patients.

     Pain is a perception that is perceived in the brain.  In most situations it is a very good warning to prevent further harm or injury to the body.  An example of this type perception is heat when one touches something hot that can destroy tissue, create a burn, and allow for penetration of bacteria and other pathogens into our body in the exposed area.  At the moment of touching the hot item we do not know it is hot and destructive.  Through a series of electrical and chemical reactions the process goes to the brain and there the brain will instruct defensive reactions by another set of chemical and electrical signals to our muscles to "fire" ( no pun intended (:) ) or create motion to remove the area from the heat.  That is good.

    However with the chronic pain patients the stimulus is not generally a one time cause but could be the result of injury, accident, or surgery. More difficult is neuropathic pain, a result of injury or disease to the peripheral or central nervous system.  The pain is ongoing and can be ever present for that patient.  Examples of neuropathic pain are:

Diabetics:
  • distal polyneuropathy
  • mononeuropathy
  • mononeuritis
  • radicular
Multiple Sclerosis:
  • trigeminal nerve
  • mutliple nerve roots
  • either one side or half of the body
  Neuropathic pain is often present in amputation and known as phantom limb pain, or in some patients who have suffered a stroke, in Guilian-Barre and in chronic diagnostic conditions such as fibromyalgia, restless leg sydrome, or reflex sympathetic dystrophy.   It is now believed that due to the neuropathic diseases that a new disease can develop as a result and the disease is "chronic pain". 

    The neuropathic diseases are progressive physical and chemical changes occurring in the body and if left unchecked develop a disease process of their own.

    It does not matter  if the pain is of neuropathic genisis, or from actute injury, the perception of that pain always occurs in the head, the ultimate receptor site for painful stimulus.  

    Certain medications help on very narrowly focused receptor sites in our body to allow or inhibit chemical changes.  Each of those chemical changes are predicated upon the ions of certain chemicals having specific electrical charges, either a positive or negative polarity.  If the polarity in the painful stimulus area is changed then the chemical changes can not occur and hopefully with chronic pain patients the pain processes can be inhibited.   The constant polarity changes found in interferential therapy ( IFT) are bringing new understanding to pain control and also the therapeutic results of longer, extended carryover pain relief periods are beginning to show the clinician there can be  underlying physical changes that will prevent the transmission of pain impulses to the brain and the pain cycle is broken.

   Out of fairness to all chronic pain patients the familial retort to the painful state should not include the statement, "the pain is all in your head".  A better retort would be "I'm not sure what is causing the pain but my job is to help you eliminate it or lessen the severity of the pain you experience." 

   Compassion coupled with understanding is needed.