Know your enemy” – so Sun Tzu said in “The Art of War”, long before Rage Against the Machine, or even Green Day.  If I was writing a philosophical manifesto on “The Art of Pain”, I’d coin it “Know your pain”.  As I commented previously, in The 4 Worst Things To Do When in Pain, loss of control is guaranteed to increase your “pain experience”.  In this article I’m going to explore the effect that knowledge can have over your pain.  I suppose this is at the very core of why I write these articles – knowledge is power!

It’s always amazed me how many people have tattoos and piercings and afterwards say “It wasn’t that bad”; it looks really painful to me.  But perhaps knowing what’s about to happen makes it much more tolerable?  Change the scene and imagine that you didn’t want a tattoo; you were taken against your will and tattooed.  Now, do you think it would hurt?  There’s loads of research to show that having “perceived” control over your circumstances lowers your perception of pain (e.g. Tommey et al, 1991).  And in some cases, no pain is reported at all in people doing it for spiritual/religious reasons.  To put the importance of control into perspective – at the other end of the spectrum is masochism, whereby people actually enjoy potentially harmful experiences; knowledge and control is crucial to your experience.

A lack of control is closely related to fear – how scarey would it be to be tattooed against your will?  So, how is fear tied in to your experience of pain?  Massively!  In 1983 Lethem and colleagues coined the term “Fear Avoidance”, and since then legions of researchers have demonstrated that sufferers of lower back pain fair much worse in the long run if they have an unhealthy dose of fear avoidance belief (Waddell et al 1993).

Not surprisingly, there is good evidence that providing information about lower back pain helps sufferers cope (Henrotin et al 2006).

So, what are the take-aways?  Know your pain, that will make it not only more bearable, but actually less painful!  If you’d like to understand your pain better, just ask me.

Henrotin, Y.E., Cedraschi, C., Duplan, B., Bazin, T., Duquesnoy, B., 2006. Information and Low Back Pain Management: A Systematic Review. Spine 31, E326–E334.

Toomey, T.C., Mann, J.D., Abashian, S., Thompson-Pope, S., 1991. Relationship between perceived self-control of pain, pain description and functioning. Pain 45, 129–133.

Waddell, G., Newton, M., Henderson, I., Somerville, D., Main, C.J., 1993. A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 52, 157–168.

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