January 26, 2016

"So… how has your pain been since I've seen you last?"

By Dr. Aliza Weinrib
Artist painting of individual that suffers from chronic pain
Memory is less like a camera, and more like an artist's painting
We have all been there. That moment when your doctor asks you, "So… how has your pain been since I've seen you last?"

At that moment, you turn to your memory to provide you with a summary of all the ups and downs that you have been through. Of course, you remember your pain! Your pain is very hard to forget or ignore!

We often think of our memory as being a kind of camera that records what happens in our lives.

Research shows that memory is less like a camera, and more like an artist's painting. If the artist feels blue, the painting will show that. If the artist feels vibrant and full of life, the painting will show that too.

When you are in pain, your mind can more easily focus on memories of pain. This is not just true for physical pain; it is true for emotional pain too. For example, when you have an argument with a loved one, you are likely to recall many previous arguments you have had – especially if you felt similar feelings at those times. Or when you have a set back at work, you might find your mind going over previous difficulties.
When you are in pain, your mind goes through your photo album of memories and shows you more pictures of past pain, ignoring pictures of pain-free moments.
Scientists have done experiments that show how our memory of pain is influenced.

1. Our recent experiences matter the most. In one study, patients were exposed to painful heat and pressure in the lab. If the pain ended on a high note, they remembered more pain than if the pain ended on a low note, even if they experienced the same amount of pain on average[1]. In other words, the intensity of their most recent pain influenced their pain memory.

2. Pain memory depends on current pain[2]. A group of patients were asked how much pain they had over the previous week. Some of these patients had physical therapy, which gave them pain relief, and some did not. The patients who just had physical therapy remembered less pain over the previous week than the patients who did not have physical therapy, even though their daily electronic pain diaries said that was not the case[3]. Their current pain relief influenced their pain memory.
Using Manage My Pain to record your pain everyday gives you a more accurate and balanced picture of your pain, what aggravates it, and what gives you relief.
That helps you to make choices about medicines, activities, and coping strategies that work best for you. It is enough to rate your pain once a day at the end of the day. The Manage My Pain app can remind you and it takes 30 seconds.

Then, the next time your doctor asks, "How has your pain been since we met last?" you will have an answer. Tracking your pain with the app helps your doctor to see your pain and understand it. From there, you and your doctor can work together to make a pain management plan that works for you so that you can do the important things that matter to you everyday.
About the Author
Picture of Dr. Aliza Weinrib
Dr. Aliza Weinrib
Clinical Psychologist, University Health Network
Lead Psychologist, ManagingLife
Dr. Weinrib is a clinical psychologist specializing in Acceptance and Commitment Therapy for pain. In addition to her private practice, she practices as part of the Transitional Pain Service at the Toronto General Hospital. She is a Board Member of the Ontario Association for Contextual Behavioural Science and a Researcher at York University.

Dr. Weinrib guides content development as the lead Pain Psychologist at ManagingLife.

  1. Areily D. Combining Experiences over Time: The Effects of Duration, Intensity Changes and On-Line Measurements on Retrospective Pain Evaluations. Journal of Behavioral Decision Making. 1998 Feb; 11(1):19-45.
  2. Eich E, Reeves JL, Jaeger B, Graff-Radford SB. Memory for pain: relation between past and present pain intensity. Pain. 1985; 23(4):375–380.
  3. Smith WB, Safer MA. Effects of present pain level on recall of chronic pain and medication use. Pain. 1993 Dec; 55(3):355-61.