PAINWHAT IS IT?

THINK OF A MEMORABLE PAIN EXPERIENCE.

VERY BRIEFLY DESCRIBE THE INJURY, OR MECHANISM TO YOUR NEIGHBOUR WITHOUT USING ANY ADJECTIVES OR DESCRIBING THE PAIN AND THE SEVERITY.

Your neighbour will consciously or subconsciously have judged your pain and relate it to their own knowledge or experience.They think they know your pain!!!!

• Now describe your pain without using any of the following words, terms or methods:• Pain, painful, pain-like• Hurt, ouch, ow!• Cry, cried, tears• Pain score, VAS, NRS etc

IASP DEFINITION OF PAIN

An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

IASP – International Association for the Study of Pain

Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life. Biologists recognize that those stimuli which cause pain are liable to damage tissue. Accordingly, pain is that experience we associate with actual or potential tissue damage. It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience. Experiences which resemble pain but are not unpleasant, e.g., pricking, should not be called pain. Unpleasant abnormal experiences (dysesthesias) may also be pain but are not necessarily so because, subjectively, they may not have the usual sensory qualities of pain. Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons. There is usually no way to distinguish their experience from that due to tissue damage if we take the subjective report. If they regard their experience as pain, and if they report it in the same ways as pain caused by tissue damage, it should be accepted as pain. This definition avoids tying pain to the stimulus. Activity induced in the nociceptor and nociceptive pathways by a noxious stimulus is not pain, which is always a psychological state, even though we may well appreciate that pain most often has a proximate physical cause.

BIOLOGY

PSYCHOLOGY

• Negative psychological effects of pain

• Positive psychological effects of pain

DONATIEN ALPHONSE FRANÇOIS DE SADE

Marquis de Sade

- Sadism

- Sadist

SADOMASOCHISM APPEARS IN CURRENT VERSION OF THE INTERNATIONAL CLASSIFICATION OF DISEASES (ICD-10) OF THE WORLD HEALTH ORGANIZATION

• Sexual Sadism Disorder is the condition of experiencing sexual arousal in response to the extreme pain, suffering, or humiliation of others

• Sexual Masochism Disorder is the condition of experiencing recurring and intense sexual arousal in response to enduring moderate or extreme pain, suffering, or humiliation

IMPACT OF PSYCHOLOGICAL FACTORS IN THE EXPERIENCE OF PAINSTEVEN J. LINTON, WILLIAM S. SHAWPUBLISHED MAY 2011 PHYSICAL THERAPY – JOURNAL OF AMERICAN PHYSICAL THERAPY ASSOCIATION

….imagine that one morning you visit the doctor for a routine check-up, and later that afternoon the doctor’s office calls to inform you that you’re in the advanced stages of cancer and have weeks to live.... Now imagine that the doctor’s office calls back five minutes later and tells you that they mixed up your lab work with someone else’s – you’re actually in good health. You would not immediately go back to how you felt before the first phone call; rather, you would feel extreme relief, lasting for hours or even days. Note that it was not a reward (e.g., winning the lottery) that made you feel better, only the introduction and removal of something unpleasant.

SOCIAL ASPECTS OF PAIN AND ILLNESS IN GENERAL

• Male of Female• Macho men and alpha women!• North Europeans vs the world• Cultural differences in illness behaviour• Medicolegal and personal injury factors• Cost of treatment• Availability of drugs and accessibility• Addiction• Support networks• Self employed vs employee