Pain is perhaps one of the biggest fears a person has regarding their health. When there is no pain, there is always the worry that an injury will pop up one day, and the days of being injury-free will be gone. Pain is your body’s best way of telling you that something has gone wrong. But not all pain is the same, and understanding the different types of pain can not only help you figure out what is truly wrong, but it can help you understand your health to a better degree.
Pain originates in nerve endings that are found in the skin, blood vessels, nerve fibers, joints, and cranium. If these nerve endings that are transmitting pain end in a certain part of the cortex within the brain, then it is interpreted as pain. If they happen not to end here, then no pain would be realized. In other words, there can be something wrong in the absence of pain, though we are not going to discuss this situation here.
Pain can be controlled many ways. It can be controlled by physical means, such as through acupuncture, joint manipulation, massage, heat or cold. Chemical means, such as cortisone, NSAIDs, or their natural counterparts, can also control pain. And pain can be controlled by mental means such as through meditation or hypnosis. Knowing what type of pain you have is of utmost importance so the appropriate therapy may be administered. However, it is even more important to note that while controlling and alleviating pain is vital, not getting to the source of the pain can lead to dire consequences. For example, controlling the pain of a stress fracture or tendon strain is necessary to help speed up the recovery time, but dampening the pain in order to keep training can lead to more trouble than what you started with.
Pain originates from one or more of three types of pain receptors, called nociceptors – mechanical, chemical, and thermal. Mechanical stress is physical trauma such as swelling. Chemical stress may produce pain through the by-products of both inflammation and muscle fatigue (such as lactic acid). Thermal stress, such as heat or cold, may produce pain through the thermal stimulation of nociceptors. A sunburn or frostbite is a good example here. Almost all pain develops from more than one source, and usually involves a chemical component. This is because when there is physical or thermal pain, such as a muscle spasm or sunburn, metabolic by-products will be released in the body.
We are going to talk primarily about mechanical and chemical pain, since that is most appropriate for the athlete. Think of mechanical pain as stabbing, pressure, knife-like, pounding, or pulsating pain (especially when around a blood vessel). Chemical pain is pain that is described as burning, hot, or searing. This is a deep burning pain, not to be confused with thermal pain from a superficial problem.
When mechanical pain is present, from a physical injury such as a sprain/strain, it is important to use mechanical therapies to treat that problem. One way to immediately block pain is to rub the skin near or at the area of pain. This stimulates large receptors called mechanoreceptors that block the smaller nociceptors. This is also why when a person is injured, they subconsciously rub over the area that they just bumped or bruised. Rubbing over the area of injury too much can aggravate that injury. When a muscle is injured for whatever reason, rubbing deep into the tendons (the ends of the muscle that attach to the bone) can help the muscle heal tremendously faster without further damage to the injury site.
When pain is present, especially from a mechanical problem, many are so apt to go right to the anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. It is necessary to know what no physician has probably told you before. NSAIDs are only shown to be effective for up to three days following the injury. That is it. Yet, many are told to take them before and after workouts, and some take them every day even if they feel no effect. These drugs delay tissue healing and cause gastric bleeding at any dose, not just prolonged use. The reason they are so widely used is unknown, but it is a problem that has gotten out of hand. These drugs not only block pro-inflammatory prostaglandins in the body, but they also block major anti-inflammatory prostaglandins, which is not a good thing. It is now realized that for those people who feel better and have a positive pain reducing effect from taking any NSAID, there is a fatty-acid imbalance present within the body. This is the major pathway that these drugs work off of. Many people have a fatty-acid problem, resulting in pain or the inability to control pain, yet there is nobody who truly has pain from a deficiency of a NSAID in their body. NSAIDs aren’t essential nutrients!
Direct chemical pain will cause burning pain. There may be a burning gluteal muscle from sitting in a chair or riding a bike for a prolonged period. It may be “burning feet” from standing too long. Or it may be the burning of muscles from prolonged or strenuous activity. This is chemical pain, and must be treated through chemical (nutritional) means. Using mechanical therapies here will only result in temporary relief, if any. This pain is often from potassium ions directly and lactic acid indirectly. When I discussed hypoadrenia in past articles, that is where the potassium significance comes in. When adrenal function is lowered due to stress, sodium is lost (hyponatremia) resulting in potassium excess. This potassium excess can cause a lot of pain, and is extremely common in athletes. The way to fix it is to fix the stress pattern(s). Lactic acid excess exists in patients who do too much anaerobic training and in those who are unable to efficiently break down lactic acid (a by-product of sugar metabolism). This is due to either lack of proper nutrients or the liver’s inability to process the lactic acid. Inability to control free radicals produced in the body from excessive training can also produce a lot of pain.
So the moral of this story is to understand what type of pain you have to properly treat it. If you are fatiguing too quickly and have a lot of burning pain when you are training, racing, or even at rest, you need to find out what is wrong biochemically. Mechanical therapies here will have short-lasting results. If you are having structural/mechanical pain, then that is something that needs to be treated through mechanical means, along with some biochemical intervention to speed up healing time and perhaps prevent further injury, especially microtrauma. Taking NSAIDs longer than three days post injury will have an adverse effect on your health, even if you do not feel negative symptoms from their prolonged use. As always, you should be evaluated by a professional health care provider who understands at least as much as you now do.