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  • Lian Yun-Perng, Physiotherapist

Do you suffer from pain?

What is pain?

In simple terms, pain is an unpleasant experience that can be associated with actual or potential structural damage. Most importantly, it is a SUBJECTIVE experience that requires INTERPRETATION of many inputs or information (memories, emotional, pathological, genetic and cognitive factors).

Pain is easier understood when there is actual physical damage. For example, my finger hurts because I accidentally cut it while slicing carrots (Cartesian model of pain). Therefore, pain is generated from the cut and the injury.

Now what about people in pain but there is nothing physically wrong? They’ve done numerous consultations with various specialist, had many physical examinations, scans or blood test but there is no conclusive evidence about the cause of pain. (Look below)

Where did their pain come from?

A scientist called Melzack came up with a model called the Neuromatrix model of pain. He used phantom limb pain as an example because people who had an amputation were feeling pain around their stump even when the stump has fully healed. This model can be applied to anyone that has pain!

Melzack asked: “How does a person feel pain in the foot after a below knee amputation. Where is the pain coming from when there is no more tissue damage."

He argued that the pain generator cannot be in the foot, because the foot is no longer there. Therefore, the central nervous system must be more than a passive receiver of “pain signals” from the site of injury via the peripheral nervous system.

The pain generator, Melzack, thus argued, must be in the intact central nervous system.

What does this mean to you?

Most times and more often than not, doctors, physios, chiros, fitness trainers or anyone would say that “Ohhh, your low back pain is due to the degeneration of your spine/ the pain is coming from your disc prolapse/ your bad posture is the reason.” But is pain really that simple? I would like to emphasise that there are an abundance of research that doesn’t support the theory that structural changes/damage is the cause of pain.

Pain is complex and multi-factorial. It is still widely researched but there is no concrete evidence on its solution or cause. Pain can be anything that your body doesn’t agree with. It can be there when you feel threatened and it can be just like your mood. Some days it’s good; some days it’s bad.

What’s the solution?

I do not offer any solutions for pain but don’t lose HOPE. The GOOD news is, there is a way to MANAGE it and it requires YOU to participate. It is an ACTIVE process and you are INVOLVED in making DECISIONS. The way to a BETTER LIFE is to understand your current situation and to HELP yourself.

My suggestion is to find a Physiotherapist:

  1. Who listens

  2. That adopts the biopsychosocial model of health and the neuromatrix model of pain

  3. That is flexible with their approach. Meaning they will tweak their interventions according to your concerns

  4. That is genuine and patient

  5. That promotes self-care or self-management

  6. That encourages you to be as active or as “normal” as you can be

  7. That shows interest in your life

Thank you for reading.

Please drop me a question, message or simply contact me here if you need any suggestions!

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Lian Yun-Perng  

UK Qualified Physiotherapist
Bachelor of Physiotherapy

Keele University, United Kingdom
Diploma in Physiotherapy

AIMST University, Malaysia

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