Massage Therapy Journal Fall 2025

Fall 2025 • 29

Other common components of pain include: • Pain is always a personal experience that is influenced to varying degrees by biological, psychological and social factors. • Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons. • Individuals learn the concept of pain through their individual life experiences, and a person’s report of their experience of pain should be respected. • Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being. • Verbal description is only one of several behaviors to express pain. Inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain. 3 Pain vs. Nociception: Knowing the Difference and Why It’s Important Learning the distinction between pain and nociception are valuable to our understanding of how pain has both positive and negative outcomes. 4 Nociception refers to the central and peripheral nervous systems processing noxious stimuli and communicating potential damage (tissue damage, temperature increase, for example) to the brain via nerve fibers. Pain, however, is the perception of said nociceptive stimuli and its individualized interpretation. Traditionally, this means the nociceptive stimuli must surpass our allostatic load, which refers to the cumulative burden of chronic stress and life events. 5 Once our allostatic load has been surpassed, our capacity to manage further input with a regulated response is no longer possible. This is frequently referred to as our “window of tolerance.” 6 The brain controls threat perception and pain interpretation based on sensory inputs. 7 When we’ve exceeded our own window of tolerance, the brain reacts to nociceptive stimuli with either a hyperarousal response or a hypoarousal response to said stimuli. The hyper or hypo response is

Pain serves an important evolutionary function as an adaptive trait driving behavioral changes for self-protection and survival.

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the totality of the individual’s experience around the stimuli— through actual or imaginary

stimuli—combined with reactive responses and predicted responses. Both the perception and interpretation to stimuli are mandatory

for the pain experience to exist. 8 Perception or interpretation alone is insufficient for pain to be present. (Think of a bruise that you suddenly become aware of but can’t recall how you got it, for example. Once we are aware of the bruise and stimulate it, pain can be manifested. But, prior to the perception, the bruise was present with no pain symptoms.) Interpretation, too, is just as essential. Imagine a tough workout, running a marathon or getting a tattoo. For some, any of these experiences might have painful elements, while others find strength or pleasure in the pain. How many times have you heard a client describe deep tissue massage as something that “hurts so good?” Evolutionary Role and Purpose of Pain: Rethinking Our Responses to Pain Pain serves an important evolutionary function as an adaptive trait driving behavioral changes for self-protection and survival. 9,10 Pain has also led to positive societal developments, like advancements in health care and technology.

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