A few years ago the book “Pain – the fifth vital sign, by Marni Jackson” in Greenwood books caught my eye.  I spent a few minutes browsing and quickly concluded that  – it has some interesting information and some serious flaws.

I decided not to buy.  As I started working on this blog, I began to wonder whether the book had anything useful to say.  I had forgotten what I saw as negatives. Over the weekend I picked up a copy to give it a second look.  As I started to read again I got more and more irritated (pained?).

I figured out what had bothered me fairly quickly. The book takes the position that all pain is ‘bad’, to be cured or avoided.  eg. There is no HEALTHY view of pain, only a medical ILLNESS paradigm.

There is no discussion of ‘growing pains’, nor ‘healing pains’.  No consideration or thought that pain can be good – as opposed to being simply useful. There is no discussion of the ‘no pain, no gain’ sports mantra (although it is mentioned in passing).  There is no mention of ‘healthy pain’ from stretching, or from exercise, or simply from over-stimulation or release from over-stimulation.

As I drove home last night, I saw a bulletin board stating: “Pain, the best instructor – but nobody wants to go to class”, advertising Taekwondo.  I realized that there is more to ‘no pain, no gain’ than meets the eye.  I am certain that no-one becomes a world class athlete without experiencing pain.  Sometimes this pain is bad, indicating physical damage. But other times it is a sign of a healthy workout – stretching abilities to a new level, and resulting in the ability to run faster, jump higher, swim faster — without pain.

Your teacher, your boss, your coach – and your inner motivator, can be a pain.  Pushing you to new levels, new abilities, new pleasures.  When you lose a game, you might feel pain.  This pain can push you, help you grow in many different directions.  You might be motivated to concentrate harder, work harder and play better.  You might decide this game is not for you – and avoid the pain.  Or you might learn to accept the pain and enjoy the game, as a challenge, or as an intellectual and social game – smiling, laughing, discussing, remembering. When your opponent wins – you experience pleasure knowing that you will win next time.

There is also no discussion of the (wide grey) distinction between irritation (an itch, for example) and a pain. Is an itch a pain or a pleasure?  Some itches are pleasurable.  Some are painful.  And sometimes, an itch can move from pleasure to pain, or from pain to pleasure. Does scratching result in pleasure? or relief? or pain? – or all three?  If something, or someone, is annoying me – at what point does it become a pain?

For example, I’m going to sleep, but not going to sleep.  My body is feeding my brain a series of small irritations as my senses settle down. In my experience, if I focus my attention on an annoyance, it grows. Sometimes I can divert my attention elsewhere, maybe by counting sheep – and it goes away. But sometimes it intrudes until I scratch it away, or shift my position a bit – and then a new sensation starts to grow and annoy. These pains are, presumably, natural and always there – below the surface.  They only appear when I rest my senses. The deaf symbol for ‘boring’ is a sign for picking your nose – and I find that while I am waiting for the streetlight to change, I feel an irritation in my nose. Is that pain always there, below my sensory perception?

When I do my Tai Chi, or when I swim, I often feel small stabs of pain.  These are the pains of healthy movement, stretching, activation.  Sometimes I wonder if a specific pain is an indication of something dangerous – but most often I realize these are healthy pains.  My body is thanking me for moving.  I can mentally shift these pains to the ‘good’ category, and feel good about them. I know that if I linger on a pain, even a health pain, it can move to an excessive, or unhealthy pain. So I try not to linger – and it goes away. Sometimes when I am exercising, or even just moving around, even just typing, I feel a small ‘sensation’ – and I am not even certain if it is a sensation, or a pain.

Is the book interesting? Yes.  Useful?  Yes.  Incomplete? Yes.  It is a book about pain, that ignores more than half of the true view of pain.

Pain can be deficient, healthy or excessive:

Illness Health Illness pain

And pain is more complex. Pain is subjective.  Pain can be an indicator of damage from the past or problems in the present, or fears of the future. A few simple examples of the complexity of pain:

Many of our sensory systems can experience pain. Not just our sense of touch. Extremely loud sounds can cause pain.  Extremely bright lights can cause pain.    Spicy hot foods can cause pain in the mouth’s taste sensors and nose’s smell sensors. Interestingly, people who do not feel pain also do not have a sense of smell. Can your sense of balance, eg. dizziness cause pain?  I’m not sure, but pain can cause dizziness. But wait, there’s more…

Young children often experience pain when they hear very loud noises – noises that might seem normal to an adult.  These noises might be damaging the hearing systems of the young children.  Elderly adults lose their sense of hearing, especially higher tones, and might not hear noises that cause pain to and harm young children.  Elderly adults may suffer from tinnitus pain caused by exposure to loud noises. And teenagers, listening to loud music, might actually enjoy noise so loud that it permanently damages their hearing.

The elderly adult’s hearing system might be pain deficient to high tones that damage young children, pain normal to mid-tones that are too loud, and suffer excessive pain from tinnitus, caused by previous exposure to loud noises – ALL AT THE SAME TIME.

The entire book views pain as excessive – pain deficiencies and healthy pain are hardly acknowledged.  This is understandable given the author’s initial motivation – a bee-sting in the mouth, and her subsequent investigations – with medical professionals who ‘deal with pain’ on a daily basis.

Pain lies.  My osteopath tells me that ‘pain lies, but it lies consistently’.  She also reminds me that if she is not causing pain – maybe she’s not doing any good. A pain in my thumb and wrist might be caused by a muscle tension in my back – a lie, but it is possible to locate the source, with time and effort, because the pain does not ‘jump around’. It follows a well defined path.  Pain is a very effective diagnostic if used well; unfortunately – and frequently in this book, it is simply something to be avoided, or eliminated.

Pain is a healthy reaction to stress.  It is a tool that teaches us to be more careful.  In specific situations, pain is generally bad. But in general, pain is good.  We all need pain to live normal healthy lives.

Are we in a healthy state when we are ‘feeling no pain’? We might be asleep, or dead to the world or high on drugs. 

Or we might be high on life. 

We also need to learn about, study and try to understand a ‘healthy level of pain’. How can you know what are your healthy levels of pain?  It’s personal.

I’ll be 59 in a few weeks, and I’ve heard that if you are over 50, and you don’t feel any pain, you might be dead.   Lucky for me – I do feel pain.

I made a point of reading the book – I even took out my pen and marked some areas of interest.  All in all, it is a very interesting book, well written, containing lots of interesting and useful information.  It is written from a medical view, rather than a health view and thus is very different from what you will encounter on my blog. In my mind – it is a very incomplete view of the complexity of pain.

I believe in Personal Health Freedom.  I believe in my right to ‘not feel pain’, and in my right to ‘feel my pain’.  I also believe in my right to change my mind. Knowing full well that

change can be a pain.

yours in health, and in pain,


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