Restrainyourpain.com

PAIN BEHAVIORS: WHY ARE THEY IMPORTANT?

Pain Behaviors are the actions that people perform to communicate that they are suffering with pain.  Whenever I ask patients how their friends and family know that they are hurting, most reply "They just know."  If I prod a little, most people can point to one or more things that the do to communicate that they are in pain.

Here are some common pain behaviors I have noticed in my practice. Which of these do you recognize from your own experience?

• Grunting
• Grimacing
• Standing
• Shifting
• Rubbing
• Limping
• Postural or gait changes
• Crying
• Sighing
• Bracing (clutching or holding on to furniture, equipment, or affected area during movement)
• Using heat or ice packs
• Using assistive devices such as crutches, walkers, wheelchairs, TENS unit
• Reclining

What Influences Pain Behaviors
 

1.    Pain behaviors serve a function at first. (i.e. Limping and Guarding)

2.    They then can cause problems.

3.    People do not show pain behaviors just to “get attention.”

4.   You should ask yourself "At this point in time, is this behavior helping me or hurting me?"

5. If something desirable happens following a pain behavior, that pain behavior is more likely to occur in the future. If something undesirable stops following a pain behavior, that pain behavior is more likely to occur in the future. Ignoring a pain behavior should decrease the occurrence of that behavior.

 So why is it important to recognize pain behaviors?  

1.  Pain Behaviors are Ambiguous.  How is your family supposed to know what you need when you elicit a pain behavior unless you tell them.  For example, pain behaviors can mean mean different things:

• "I hurt"
• "Help me"
• "I need you"
• "Leave me alone"
• "Come closer"
• "I can't do___ today"
• "Don't expect much from me"

2. Pain Behaviors Are Powerful.  Recent research has demonstrated that viewing pain behaviors in others produces measurable changes in our brain and cardiac activity.  This suggests a hard-wired predisposition to react to pain in others. This means that people may not respond to you in the way you intended.

SO WHAT DO WE DO ABOUT IT?

1.  Identify Pain Behaviors:  Pay attention to the things you do when you are hurting, and more importantly, pay attention to the response you get from people close to you.
2. Eliminate Pain Behaviors:  

•  PT/OT
• Improve posture
• Decrease narcotic pain medication usage
• Avoid unnecessary rest
• Get involved in other activities via distraction
• Avoid talking about the pain
• Remind those close to you what you need

For more information contact Dr. Wolfson at dr.aaron.wolfson@gmail.com.  Or visit: www.restrainyourpain.com.