Pain is a perception produced in the brain. This perception is often associated with some bodily damage, but it does not have to be. Usually there is a good relationship between the amount of bodily damage and the intensity of pain; however, we all know of situations where there is extensive damage but little pain, or situations where there is no damage and a lot of pain. How can this be?
The production of pain uses biological signals in the peripheral body to sense and transmit information about damage or potential damage (e.g., in bone, muscles, nerves, organs, etc.) to the central nervous system (i.e., the spinal cord and brain). If these biological signals are sufficiently meaningful to the brain, then they can enter into your consciousness as pain.
Pain is defined by the International Association for the Study of Pain (IASP) 1 as being both a sensory and an emotional experience. You need both in order to experience pain. The balance between sensory and emotional drivers may shift from time to time but both are always needed and when both are active, it is always real pain.
The NFA realizes that the topic of pain can be confusing to both patients and clinicians. Some of the confusion stems from assuming that pain arises solely from a damaged body region. It does not. Some of the confusion may also come from assuming that brief acute pain is processed by the brain in the same way as more long-term or chronic pain. It does not. Different treatments are likely needed for these different forms of pain.
The NFA seeks to provide the FM community with high quality education about how different types of pain are produced and what treatments can be matched to the different drivers of pain. The goal of the NFA is not to promote any one form of treatment, but to offer broad education about what pain is and what has worked for others, so that individuals can make informed decisions about their own path to optimal pain management.
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Merskey H, Bogduk N. Classification of chronic pain: description of chronic pain syndromes and definitions of pain terms. Seattle: IASP Press; 1994
