April 12, 2016

Two kinds of pain: Physical and Emotional

By Dr. Aliza Weinrib
Screenshot of Daily function feature to manage chronic pain
Daily reflections help you track the meaningful activities that matter to you
Everyday, patients tell me about two kinds of pain...physical and emotional.

The first kind of the pain is the obvious one. This is the physical pain they feel in their bodies.

Patients tell me:
  • how intense this pain is ("It is 6 out of 10")
  • what it feels like ("It burns like electric shocks")
  • where the pain is located ("It's in my back")

My patients can track all of this information in Manage My Pain, which is very helpful for me as part of their health care team because then I can see the pain pattern over time.

Patients also tell me about the second kind of pain, one that is just as real. It is the emotional pain of not being able to do the things that matter to them.

For example, patients tell me:
  • "The hardest part is that I can't work."
  • "My favorite thing is going for long bike rides and I miss it so much."
  • "I really want to make a big birthday party for my kid, but it is too much."

Both kinds of pain are important.[1] That's why introduced a way to track your meaningful activities on a daily basis. When your doctor prescribes pain medicine, the goal is to help you in two ways:
  1. For you to have less pain
  2. For you to be able to do more of the meaningful activities that matter to you. Now you will be able to track that in the app.
Experts agree that it is helpful to track both your pain and the activities you can do
When you track both, it gives both you and your doctor a fuller picture of how you are doing from day to day. It can help you and your care team to figure out what treatments and coping tools help you to do more of what you most want to do.

We have made it simple to track your meaningful activities. You are all experts on rating your pain from 0 to 10 using the pain slider. Now, at the end of the day, the new Daily Reflection asks, "What did you do that mattered to you?" You can rate your day from 0 ("I did nothing that mattered to me") to 10 ("I did everything that mattered to me"). Then, if you choose, you can select the meaningful activities you did from a drop down list, including things like spending time with people you care about or doing an activity that you enjoyed. As always, you can edit and personalize your list to reflect the activities that are most important to you, so that you can track when you are able to do them.

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.

Dworkin, R. H., Turk, D. C., Wyrwich, K. W., Beaton, D., Cleeland, C. S., Farrar, J. T., ... & Brandenburg, N. (2008). Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. The Journal of Pain, 9(2), 105-121.