Massage & Bodywork

November | December 2014

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34 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 4 CLASSROOM TO CLIENT education Understanding Pain By Anne Williams A 1999 national survey found that approximately 50 million Americans live with chronic pain caused by accidents or disease, while an additional 25 million suffer acute pain resulting from surgery or an accident. Two-thirds of the people surveyed had been living with pain for more than five years. 1 Researchers in 2000 found that 36 million Americans had missed work in 1999 due to pain, and 83 million reported that pain affected their participation in activities of daily living. 2 Regardless of how and where you practice massage, you will encounter clients living with pain. The judgments you make about the client's story, your knowledge of pain and its causes, your personal experience with pain, and your personal beliefs about how people should respond to pain, are likely to influence how you interact with these clients and the quality of the care you provide. This column defines pain, discusses the impact of chronic pain on activity levels and quality of life, and identifies reliable massage techniques that reduce pain. PAIN DEFINED Pain is an unpleasant physical and emotional sensation associated with tissue damage or the immediate potential for tissue damage. This definition describes pain that arises in response to physical trauma, not as a result of mental or emotional suffering. The intensity and quality of pain experienced due to physical trauma vary among individuals because of genetics, ethnicity, gender, past experience, present expectation, cultural background, situation and context, and a variety of other psychological and physiological factors. Personality characteristics, emotional reaction patterns, and mental state can play roles. For example, in a study conducted on depressed patients of the same age and sex, patients with more severe depression reported greater occurrence and sensations of physical pain than patients with less severe depression. 3 It is important to point out that the pain perceived by a client may not always seem proportional to the degree and severity of tissue damage. Pain is a highly subjective and personal experience; this fact has prompted the nursing profession to widely adopt the following definition of pain: "Pain is whatever the experiencing person says it is, existing whenever the experiencing person says it does." 4 Pain is classified and further defined by time, its location, tissue type, and how it is generated, as shown in the table on page 37. CHRONIC PAIN Chronic pain is pain that persists for a period of time past the point of typical injury recovery. Most people respond well to treatment following an injury and return to full strength

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