Physical pain is a subjective experience. Even if it is produced by the same stimuli, its intensity varies, both in different people and in the same person in different situations. The International Association for the Study of Pain has defined pain as “an unpleasant sensorial and emotional experience associated with actual or potential tissue injury”. So pain is not only physical, but also emotional. Pain tolerance is influenced by the area in the brain responsible for control and focus of attention and thoughts. In other words, the more easily we can detach ourselves from pain and focus on other aspects, the more easily we can tolerate it. The brain can memorize and categorize a pain so that when we have a similar stimulus we can “remember” the pain we had and thus our perception is altered (for example, if we had a menstrual pain the following month we can anticipate that pain and feel it as strong or even stronger). If the stimulus is repeated, the pain becomes chronic. Pain perception is influenced by our mental state, when we are depressed or anxious we feel pain more intense.
It is not difficult to draw the conclusion from the above summary how patients with autoimmune rheumatic diseases perceive pain. Let’s say that an ordinary person gets injured, the tissue becomes inflamed and painful. Through the perception of pain, the person protects that area, allowing it to heal. He may take an analgesic or an anti-inflammatory, but soon the wound heals. The brain has memorized the pain, but the possibility of having exactly the same wound in the same place is small. In the chronic patient, the inflammation is continuous or improves for a period and returns, in the same place, in another or in several places at once. The perception of pain is amplified in all the ways I described above. And what can we do? Well, we have a solution: “pain tolerance is influenced by the area in the brain responsible for controlling and focusing attention and thoughts”. There are two possibilities: either we do something to distract ourselves from the pain, or on the contrary, we focus our attention on it and “subjugate” it.
I will tell you how I came to this conclusion. In my youth I had some terrible menstrual pains. 15 years, month by month I was dying and coming back to life. I was rolling on the floor and screaming until I had no voice. Once, while I was doing my monthly number, I noticed a wet spot on the ceiling that was getting bigger as I could see. Do you know how my pain went away? Immediatly. The best pain reliever. I went to the neighbor above, a lonely old woman who had forgotten to turn off a faucet and I removed the carpets, I mopped the floor for about 2 hours. Nothing hurt anymore. I completely detached myself from the pain. The second experience, also with menstrual pain: I was in an astrology camp, at a fancy hotel, I was staying in the room with a very nice girl, we were the only ones who had come unaccompanied, and the organizer put us to stay in the same room. When that well-known pain woke me up the first night, I panicked. I could see myself doing a circus in the hotel, scaring my roommate, the organizers… So I decided to suppress my pain. I had tried once before, with relative success, but I couldn’t maintain my concentration for a long period of time. But I was desperate (I had in mind a recent incident where I had been stretchered out of the mall in full view of all the shoppers, I didn’t want to be the victim anymore). So I put my hands on my abdomen and started breathing consciously. I imagined the pain as a lump in my abdomen and slowly began to shrink that lump. It took me a while, a few hours, but I did it. I got over my pain and didn’t become the negative star of the hotel. In the morning my colleague was scared by how I looked and asked me if I was feeling well. Oh… if you only knew… I also use these methods for rheumatic pain. I control them, I don’t let them control me. It took a conscious effort at first, but as I practiced them, they became a reflex. I sit face to face with the pain until I put her muzzle on her paws, like an obedient puppy.