Why pain is important

Helen Cowan

Goldilocks sought porridge, a chair and a bed that were “just right”.  When it comes to feeling pain, exercising with pain, or treating it with medication, too little can be as bad as too much, and the concept of “just the right amount” applies again

The Goldilocks Principle 

Finding the median, the middle or the appropriate is important in everything from astrobiology to economics. Professor Stephen Hawking once said that, “like Goldilocks, the development of intelligent life requires that planetary temperatures be just right” and economists talk about a “Goldilocks economy”. In everyday life, having just the right amount of food, money, sunshine—and even stress—is important (with low to moderate levels of stress being necessary for heathy growth). For everything there is the perfect amount. 

 

The sensation of pain 

in pain

“I’d rather hurt than feel nothing at all” sang Adele, and being unable to feel pain threatens our very survival. Without pain, we do not reflexively recoil when burned or injured, allowing the damage to go deeper still. We are also not prompted by new pain to seek medical advice, when it might be pointing to disease within.  

Author Philip Yancey writes that, “pain is not an unpleasantness to be avoided at all costs. In a thousand ways large and small, pain serves us each day, making possible life on this planet. If we are healthy, pain cells alert us when to go to the bathroom, when to change shoes, when to loosen the grip on a mop handle or rake, when to blink. Without pain, we would lead lives of paranoia, defenceless against unfelt dangers.” 

Too much pain though is hard to bear and occurs through disease (such as arthritis or cancer) and even in the absence of disease, when the nervous system becomes strangely super-sensitive to pain (in a condition known as hyperalgesia). In allodynia, something as soft as a feather-light touch can feel more like a burn from a blowtorch.  

 

Exercising with pain 

exercise pain

Getting it just right when it comes to exercise and rest is important for the person in pain. Neither prolonged bedrest nor “boom and bust” are the answer.  

Phil Sizer, specialist in chronic pain, explains how, in the boom-bust (or “overactivity-rest”) cycle, people in pain do as much as they can until the pain forces them to stop, and then they crash out. In other words, they go from being physically flat-out (pushing themselves to the limit) to literally flat out (collapsed in bed)—and it can lead to a loss of function and a perplexing increase in pain. 

Writing in the British Medical Journal in 1947, meanwhile, a Dr Asher describes the “dangers of going to bed” (for too long), detailing possible damage to the lungs, the skin, the circulation, the bones and the mind.   

Slow and steady wins the race” when it comes to exercising with pain. Pacing yourself is important. 

 

Taking painkillers 

on the floor

When you’re in pain, you don’t want to be undermedicated (and let the pain persist) nor do you want to take too much medication and risk serious side effects.  

To avoid using a sledgehammer to crack a nut when deciding upon the type of painkiller to use, the World Health Organisation developed a “stepladder” system in 1986 which allows doctors to match the painkiller prescribed to the pain intensity, carefully “stepping up” the strength of painkillers used as needed, starting with paracetamol and ibuprofen, moving to codeine, and adding strong opioids such as fentanyl and morphine only when the pain is really bad. 

Not named on the stepladder, but especially important in chronic pain relief, are some antidepressants and antiepileptic drugs (which also happen to have painkilling properties). Cognitive behavioural therapy, meanwhile, can help you change the way you view the impact of pain on your life and your future. 

 

Learning Lagom 

Lagom is a Swedish word meaning “just the right amount” and chef and author Bronte Aurell describes how it “applies to absolutely everything, from coffee to sweets to clothing to the car and the weather.” It could be applied to pain and its management too.  

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