Understanding Pain :: Nationwide Children's Hospital

Understanding Pain

Pain is an alarm signal that occurs when the body is in danger. Think of it as protection from harm.

Pain is a combination of four things:

  1. Feelings
  2. Thoughts
  3. Behaviors (actions)
  4. Body Signals

It may be helpful to think of pain as a puzzle. Notice that the first three ingredients for pain have to do with the brain. Body signals by themselves cannot cause pain.

If anyone has ever told you that pain is in your head – it is! Your brain decides what body signals mean. Your feelings, thoughts and actions help your brain decide what to do about the pain.

What is acute pain?

We most commonly experience short-lived pain, also referred to as acute pain. Acute means brief (short) and severe (very bad). Acute pain is caused by many things.
 
Here are some examples:
  • Cuts or burns
  • Surgery
  • Broken bone
  • Sprained ankle
Nerves send danger signals to the brain when acute pain happens. The danger signals protect you from more harm. 
 
Here are some examples of how acute pain protects you:
  • It tells you to take your hand off a hot stove
  • It tells you not to walk on a broken foot
  • It tells you to rest so you can heal
Acute pain may last a few seconds (a pinch), a few days (a paper cut) or weeks to months (broken bone or sprain.) Acute pain goes away when your body has healed to the best of its ability and the danger is gone.

When is pain considered a chronic pain condition?

If acute pain does not go away when it should (usually three months or less), it is called chronic pain.
 
Chronic pain happens when the body has a very sensitive response to something that is no longer harmful.
 
Some chronic pain conditions have a well-known cause, but most chronic pain goes on with no clear reason. In both cases, the body’s response is more intense than it should be.
 
Think of chronic pain as a car alarm that is not working right. The car alarm is supposed to go off when someone breaks in (danger). Sometimes a car alarm is sensitive to something touching it that makes it go off when it shouldn’t (threat, but no danger).
 
A very sensitive alarm might go off when nothing touches it, like a strong wind (no threat, no danger). 

Why doesn't my chronic pain go away?

Nerves transport body signals to the brain. There are natural “gates” in the nerves that open and close to let signals through or not.

Think of nerve signals like a railroad crossing gate. Trains pass through if the gate is open. In the case of chronic pain, the gates are stuck open. When the gates get stuck open, pain signals have free access to the brain.

Think of many trains going through the gates right after one another. The gate has to wait a long time before it can close. It might even get stuck and stay open. 

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