Читать книгу Why It Hurts - Dr. Aneesh Singla - Страница 16

In medicine, when we treat pain without deciphering the underlying cause, we are making a grievous error. It’s like shutting off the power to a burning building because the sound of the fire alarm is bothering you. You have to put the fire out. If the body heals on its own from injury, medical intervention isn’t necessarily needed, but when pain persists, the underlying cause must be resolved to restore balance. Once the problem is addressed, the pain has served its purpose, which is to get the person to identify the damage and deal with it.

When you get a small cut on your skin, you heal quickly and often with no visible mark. There may be a lesson to learn from this injury, such as avoid sharp objects. A deep wound, on the other hand, usually stays with you as a scar, a visible reminder of an injury in addition to the memory of the pain to remind you of what not to do next time. Pain teaches you to avoid a similar injury in the future by adjusting your actions and behavior.

“But why am I in so much pain for months after my injury?” Patients often ask me why their pain persists so strongly and for so long after an injury. They are frustrated at the slow healing process that limits their activity for weeks to months. I remind them that the pain remains to ensure that they are particularly careful around that part of the body so that it can heal completely.

When we see someone with a lot of scars, we infer that they have endured a lot of pain in their lives and that they are wiser and more experienced as a result. Scar tissue is used as a metaphor for physical or psychological trauma. When we learn from pain, we call it adaptive—it helps us adapt ourselves to the world.

Instead of looking at pain as a discrete, traumatic event, let’s try another perspective. Let’s say you’ve decided to start playing tennis. When you start practicing a new sport in earnest, it’ll hurt. Beyond general muscle soreness, your hands will hurt where you adjust the strings and grip of your racquet. When you swing your racquet, there will be friction in places where your hand grips the racquet. Over time, your fingers will develop tears and abrasions in these areas of greater than normal friction. Eventually, protective calluses will form over these areas. Thus, injury, pain, and healing lead to further protection through the adaptive process.

Pain helps us grow in awareness of our environment. Darwin would agree that children with CIP are at a significant survival disadvantage. They can’t help but repeatedly hurt themselves, causing tissue injury, and they typically die prematurely.

As much as I would like to be able to turn their pain off in order to end their suffering altogether, patients with chronic pain need their capacity for pain as much as ever. I have had numerous patients discover serious illness or injury thanks to pain, whether jaw pain from a tooth infection, abdominal pain from appendicitis, or flank pain from a kidney stone. Even though they had long wished they could turn off the alarm system, when these conditions were found and treated promptly, they were able to be thankful that they’d had it on.