The injured worker’s capacity for pain tolerance

pain-scale

Let’s talk PAIN. I am, like many of you, in severe pain. In my injured opinion I believe there is a big difference between the concepts of pain treatment and pain management, and quite often when you – the injured worker- participate in pain treatment, you are in fact -somehow-postponing your ultimate requirement, namely that of learning pain management. Have you ever thought: “soon after I settle my workcover case, and I know my family is okay, I am going to kill myself rather than live with this pain”?

The injured worker’s capacity for pain tolerance

Pain tolerance refers to the amount of pain that an injured worker (or a person) can withstand before physical and/or emotional “collapse”. Conversely pain threshold is the minimum “stimulation” need to produce the initial pain.

People often falsely believe that repeated exposure to pain increases an injured worker (or any person’s) pain tolerance. In fact, the opposite is true: Repeated exposure to pain increases the injured worker’s response to painful stimuli.
Intense/severe pain makes the cells actually more responsive/sensitive even to small pain stimuli in the future.
That is why injured workers who are victims of a painful physical trauma, and those in acute pain, should and generally are relieved of pain as soon as possible, in order to prevent pain sensitisation.

It has been said that men generally have higher pain thresholds and greater pain tolerances than women.

Having someone (i.e. partner, spouse, close friend, psychologist) provide emotional support during the trauma/pain also reduces the experience of pain.

That said, there is the (false) belief among many chronic (severe) pain sufferers that they can never tolerate their pain and that they should never be forced to do so. People in severe (chronic) pain also reason that narcotics should never be diminished or withheld if it clearly blocks (some of) the pain.

The fact of the matter is injured workers /people who suffer from chronic, painful injuries don’t know their own capacity for pain tolerance, …

…and there is still quite a bit medical treaters (incl. psychologists) can do to ensure they manage their pain maximally.

I had a fellow,  severely injured worker tell me that “soon after my workcover  case is settled, and I know my husband and kids are  okay, I am going to kill myself rather than live with this pain. Eight years later, she is still alive and amazingly “active”, even though her pain is worse than it was 8 years ago.

Not long after this, her younger sister was injured and the sister stated “if I have to live with the pain my sister has had, I will kill myself.”

Have you ever thought about killing yourself rather than to live with your pain? I certainly have, years ago and again more recently… and yet I am still alive….meaning that I probably still have not figured out my own pain tolerance….and resilience.

 

[dictated by WCV and manually transcribed on behalf of WCV]

 



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9 Responses to “The injured worker’s capacity for pain tolerance”

  1. I have thought of ending it all… the light poles looked so very tempting, but I have teens, and I couldn’t stand the thought of them having to go through the trauma.
    I am alive, I can walk a little, and even though by the end of each day my body and head is so very painful, I can still participate in life.
    I can see my grandson, I can read for short periods… and until this week have remained at work. I am waiting on approval for a repeat RFD.
    I am enrolled in the Pain Management clinic at our local hospital, and although they don’t support my search for something to stop the pain in my neck, shoulder, back & arm they are helpful. Slow to start, but they do help you to understand pain and why its there, the difference between acute and chronic and harmful v’s non harmful.
    It doesn’t help when you get put through the wringer by your case manager though. Sometimes I feel so low, I actually wish the same pain on them…. I’m sure once they experience what we have to go through they would change their tune…

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    • Woowoo,im so sorry to hear that you are in so much pain.I think we all have had that thought go threw our heads,i know I have.But you are a fighter as we all are.Yes I agree that case managers need to have an accident and feel pain and as some doctors.And I have seen it with a doctor who was a arse and all the rest.He was told he had cancer that’s sad but boy did it bring him down to earth,he found himself on the other side of the desk,waiting in doctors rooms,being called out as mr not dr no body cared that he was a doctor he was just like everybody else.It took him quite awhile to recover

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  2. Pain, well where do you start and where do you end? I’m in chronic pain all the time, it never goes away it only varies in the depth of the pain. I went through drs telling me it’s all in my head, I’ve been told I should be put in a mental health clinic because I had the operation to remove the pain , but it hasn’t. All it’s done is made it so I can move around a small bit and do a few things. My surgeon had told me Don’t worry in a few years I will see you like I saw this other gentleman who had a numb thumb, and I asked him how’s your numb thumb? And the person couldn’t remember it until I reminded him and he touched it and said still numb. Now I really don’t understand how a numb thumb is similar to my chronic l5 and s1 nerve pain and limp I have. I have even just had a neurologist do a rest with all these electrodes by computer which you cannot fake and it came back with still have major damage to the nerves and the neurologist said even though you have already had surgery (fusion) to fix this something else needs to be done in order to greatly improve it. However my surgeon sent me on my merry way saying there’s nothing else he can do as he’s done it and of course there’s damage there but I will see you in a year for a check up. My thoughts about all this is once it’s settled then yes I’m going to do myself in. I did try already with the drugs in on as the pain was way to much, when the drs found out which was when it was unsuccessful they changed my medication around. Now I’m still in constant pain and some days worse than others but….. The new medications have made it so it’s just and I mean just tolerable. Like previous people have said but we are still alive now, so yes we are but will we stay that way?? Especially with Australia’s stupid legislations and Acts that are years old and not based correctly on what you truly should be entitled to as there’s still all our stuff that needs to be paid including specialists and others in the medical field. I HATE who I have become from all of this! Pain changes your whole personality.

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    • Dear Abbracadabra,yes pain does change you and it ages you to.People have walked past me not knowing who I am and I used to work with them everyday,so I know what you mean.Have you try nerve blocks they can work a lot or a bit I found them worth trying.I went to Dr Bruce Mitchell at Metro Spinal Clinic look him up on google have a read see what you think.Im so sorry you are like this life can be a bitch.God bless

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    • Just been to another group session at the pain clinic…
      Apparently there are moves to make Chronic Pain a Listed Disease… in its own right. There have been some more studies done, using MRI to show the brain function when nerve paths are damaged…
      @Abbracadabra, what they are telling me is that the initial healing period has passed… nerve damage cannot be fixed it misfires signals to your spinal column and to your brain…

      So I have confirmed bulging discs at c5/6, t2/3 and at at least 3 levels in the lumbar region, I have other areas in the Thoracic level not imaged, but have been told I have symptoms of Thoracic Outlet Syndrome, I also have degenerative changes. They are saying surgery wont fix my pain, and could make it worse…
      Pain is not taken into consideration for calculating workcover payouts, and if surgery isn’t required and you are classified as “stable” you get a lower WPI…
      I dont want more pain, I have more than enough. But I am not being given the option of surgery to fuse or replace the damaged discs… how do they know for sure the procedure won’t work… I have had a caudal injection, which worked well for about 3 weeks, and a RFD which lasted 8 months, before starting to wear off…
      I am a single parent, after my partner of 6 years left in 2009.
      My RFD was done at the Metro Spine clinic, I was referred by Dr Steve Jensen from Footscray, I had my MRI’s checked by Mr Cleaver, from the Gold Coast, and he would do the surgery, but I’d need a full consult first.
      I’m at odds because of all the confusing advice… I’d like to see another Dr just to clarify one way or tother… BUT it is important to remain positive. My kids hate me at times, but they know whats happened. They see me try. Thats all one can do…

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      • @Woowoo – “Pain is not taken into consideration for calculating workcover payouts, and if surgery isn’t required and you are classified as “stable” you get a lower WPI…”- is not necessarily true, in fact the opposite can happen as you are not considered “salvageable” and the impairment assessment assesses function. Thus you may receive less WPI after surgery. Same with other injuries; i.e. if you have a damaged shoulder tendon and can’t lift the arm, and it can’t be fixed you will get more than if the tendon is fixed and you can lift your arm again.
        I feel for you. Whether or not you have surgery, it is important you make an informed decision as surgery is not always the answer either, especially in “salvage” cases. You’re damned if you don’t and damned if you do.
        This reminds me of workcovervictim who underwent a salvage operation to her shoulder after many failed ones and although the idea was that she would have less pain with a total replacement (reverse prosthetic) she has more pain than before and this 5 odd months post-op. She would have regretted not trying it, but now she regrets having had it done too….

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        workcovervictim3 March 24, 2014 at 8:06 pm
  3. Tony
    I to have had people walk past me and not recognized me when I use to work so closely with them everyday ;( it’s upsetting. I’ve been told to use a walking stick but am to vain. Yep I know I shouldn’t be but I think for gods sake let me have some dignity.
    I have tried two nerve blocks before I had the operation and both were unsuccessful , I have tried a nerve block since the operation and it put me in bed for 3-4 days because it made the pain worse, I’ve also had an epidural steroid injection which is in the spinal area and I was also in bed again for another 3-4 days afterwards because of the pain, again it did not work. My most recent operation from my pain specialist was a month ago, it was Pulsed Radiofrequency Neurotomy now this afterwards for me personally i found very painful for about ten days afterwards. Eventually it came back down to the bare minimal of pain relief. During the time though after I had it I did try to cut my leg off but stopped because of the pain.
    Look I don’t know what’s left on the list for me? I have no idea how I’m going to make it and survive. Thanks for your kind words tony I will endeavor to look up the fellows details you have kindly given me and I’m also going to try a Dr Neil Cleaver whom I have also benn told is good.
    I just hope my two boys 16 & 12 will still love me as they have recently told me I’m not a mother anymore I’m like a child that needs help all the time. And my husband goes through stages where it seems he absolutely hates me. All this upsets me and makes it all seem to hard. Yes I’m seeing a psychiatrist and psychologist but they are fantastic as they think my feelings and behaviour are fine and that I’m a lovely person. I know I was on the rocks with my partner before this happened and now I suppose he’s thinking oh god this makes it worse.

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    • Oh Abbracadabra,im so sorry for you.When I read your reply it bought tears to my eyes.You are a lovely person and don’t ever forget it.Your psychologist and psychiatrist are right please keep going to them your behaviour is only natural.I wish those around you would see how lucky they are to have a mother no matter what condition she is in,i don’t have a mother and would do anything to have just five more minutes with her.I send you a big hug and my thoughts are with you,GOD BLESS.

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    • I understand how every one of you feels . Chronic pain makes life a challenge for sure , add it to this workcover battle and it’s impossible not to throw a pity party . Does one ever get used to functioning on a Dulled down brain from narcotic side effects . I’ve improved enough now to cope with daily existence but am left grieving for my once healthy pain free self .

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