Why the Degree of Injury and Degree of Pain Do Not Always Align
College basketball fans won’t easily forget March 31, 2017, when University of Louisville sophomore Kevin Ware suffered a gruesome leg injury on National Television. But perhaps the most surprising part of the injury was that Ware reported no pain, was able to call his mother and tell her he was “fine”, and followed the score of the game on the way to the hospital.
This story is an example of how the degree of injury and degree of pain are not always equal. This is because pain is an output from the brain, and is much more complex than simply correlating with anatomical tissue damage. The brain directs pain to tissues that it suspects are in danger, although sometimes it is incorrect in its assumptions.
Pain is useful for helping protect damaged tissues, but problems arise in situations where there is no longer tissue damage but the brain is still sending out a pain signal. This contributes to chronic pain, which is pain that has been present for longer than 3 months, which is the time typically required for tissue repair to occur.
In situations with chronic pain, it is sometimes necessary to work through the pain to rewire the brain’s pathways. This can be a difficult concept for a patient to grasp, as they have to learn that they cannot trust what the pain is telling them and that pain is “OK.” Your Physical Therapist can work with you and support you to use movement in order to desensitize your nervous system and improve your function through a specific Physical Therapy treatment plan.
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