by Jenny England

It is remarkable how painful a small splinter stuck in the corner of a fingernail can feel, especially if you are also in a down mood. Just as amazing is the way a mother can soothe the headache of her small child with a light kiss to their forehead. How intriguing also are those times when we don’t feel any pain until you become fully conscious of an injury. Such is the mystery of pain.

As the human experience of pain is such a mystery it is too simplistic to consider even consulting a dictionary for a definition when trying to understand it. If we did all we might find is:

Pain, n mental or bodily suffering or distress (as opposed to pleasure)

This definition certainly addresses the distress of pain but I am tempted to change it a little to:

Pain, n physical or psychological (mental, emotional or spiritual) suffering or distress (as opposed to pleasure)

At least this enables us to incorporate some of the other dimensions of pain not acknowledged in the first definition but just as viable and important in my opinion. Still not a good enough definition though.

According to recent statistics, one in five Australians experience chronic pain on a regular basis. So, does the universe conspire against that proportion of us. Or does a roll of a dice secure this distressing fate to so many individuals. No…as humans we are merely sentient beings with sensitive nervous systems attached to a brain that has been wired to respond to sensations that alert it to an injury of some sort.

For three and a half years I have been trying to deal with chronic neuralgic pain in my left jaw. At worst it is excruciating and debilitating affecting my ability to think, eat, talk work and sleep. At best it is a constant ache subdued by medication. So, how did all this begin? With an irritated trigeminal nerve I now believe. I thought it was a toothache and after consulting two dentists in desperation I opted for a tooth extraction. This not only irritated the nerve more it also made the pain unbearable.

The hardest part then was … getting help - neither the dentist in question or my GP were much help. Over the counter painkillers were a waste of time and money. In desperation again I admitted myself to Northside Clinic where I finally relaxed a little and was given medication, group counseling and support. Then after chasing around many other specialists and alternative therapies, I eventually found my way to the Pain Management Clinic at RNSH. There I found another source of support and assistance.

I am not sure how I feel about medication for chronic pain. Nerve pain does not respond to simple analgesics and the side effects of many of the other painkillers prescribed are often harder to handle than the pain itself. Obviously large pharmaceutical companies are making millions of dollars developing new drugs all the time but as yet I haven’t come across anything that relieves the pain and gives me the quality of life I used to enjoy. I finally opted for a low dose of amitriptyline which subdues the pain a little. Now, due to the sedative effects of the amitriptyline I no longer have the confidence to drive and it upsets my digestive system, makes me dizzy and at times, confused. On the plus side, most of the time I sleep a lot better.

Pain is not just about physical injury. I clearly remember the day when clasped the pain in my belly in my local church listening to the music specially chosen for the funeral of a close friend. I listened intently as her husband spoke of her long-term pain and suffering and the final relief her death had brought. I reflected on my own life. Despite a lifetime of all kinds of endings, the end of my marriage was the one of the hardest ones to bear. For years after we separated, I was in pain …emotional pain, and it hurt like crazy.

Current research is revealing that our experience of pain has more to do with our perception of it than the severity of the actual injury. How we react to the pain then adds another dimension to our experience. The psychological trauma involved with any painful event (whether an injury to or body, ego or emotional state of wellbeing) can persist long after the original event, prolonging the pain. Our understanding of perception is still in its infancy. However, it is increasingly becoming apparent that what we perceive through our senses is closely linked to our memories and imagination (encompassing out beliefs, thoughts and emotions). Just as our pain is intensely personal, our perception and measurement of the pain is only ever personal.

I am learning a lot from my personal journey with chronic pain. Some of the main things include:

1. Alleviating the distress of pain by reducing stress and anxiety by medication in the first instance can make it more manageable.

2. Identifying the source of the pain and diagnosing whether it can be treated easily or not and predicting whether it will diminish over time, also helps.

3. It is important to seek out the most appropriate treatment as soon as possible, whether conventional or complimentary. Due to the complex nature of pain, alternative therapies such as acupuncture, Alexander Technique, reflexology or even hypnotherapy, often work.

4. Finding supportive medical professionals and family and friends is essential to maintain a sense of wellbeing.

5. Walking is a great pastime for pain relief. Not only is it excellent exercise but it helps by taking you away from yourself into the community and you get to meet some lovely people and their dogs! Ditto for gardening which also adds a creative dimension to your activities.

6. You only need to deal with chronic pain in the present moment. Remembering old pain and hurt or imagining and anticipating future pain only makes it worse. Meditation, mindfulness and relaxation really help.

So, is a day without pain possible? Probably not. It’s just a matter of learning how to live with it. And that ain’t always easy.