example of the many subtle ways pain protects you below the level of conscious thought happens when we run. If you pay attention during a run, you’ll notice yourself automatically making adjustments to your gait as you go. This is the pain reflex warning you whenever an area of your body experiences too much repetitive stress so you can adjust your stride before lasting damage—a torn ligament, a sprained ankle—occurs.
It’s not quite as immediate a reaction as the blink reflex, but it still involves input that travels from an extremity through your spinal cord to your brain, where it is processed. In response, your brain sends instructions to compensate. While it’s likely that you process this information subconsciously, the fact remains that pain made you change your behavior. If you couldn’t feel that pain, you’d risk getting a blister, a stress fracture, or worse. Pain provides your brain with constant feedback for adjustment, both consciously and subconsciously, every minute of the day.
In A New Earth: Awakening to Your Life’s Purpose, Eckhart Tolle writes, “The body operates by an intelligence that we don’t fully understand.” I believe we can learn to recognize and appreciate the intelligence and wisdom of the human body when it comes to pain. We have evolved with the spirit of survival as our most paramount goal; pain facilitates that survival. If we do not see pain’s value, I would argue that we threaten our own survival.
Pain as a Tool for Growth
Humans thrive on competition in sports, academics, business, the arts, and every other arena. Through both winning and losing, we learn, better ourselves, and set benchmarks for future growth. We compete against others and we compete with ourselves, pushing through that extra repetition at the gym or trimming five seconds off our three-mile run. Pain is essential in honing our competitive edge. It tells us how far we can push and when to back off. When you feel the burn of lactic acid (inflammatory pain) during the last mile of your run or the last set of your workout, you know you are close to your physical limit. That sensation tells you that you can push just a little bit more before you rest in order to maximize the benefit of your training session. When you push yourself to the threshold of discomfort, your muscles tear microscopically. When you rest, they rebuild stronger than before. Pain is essential to this growth process.
The Golgi tendon organ is the sensory receptor that helps us know our limits when we stretch our bodies. Without it to warn us, we would extend our muscles beyond their limits, tearing them and even damaging our joints. Pain regulates both the stretch and the contraction, keeping us safely between both extremes. In order to see the benefits of stretching after a workout, you have to gently push against the limit set by pain. As Benjamin Franklin wrote in his classic essay, The Way to Wealth:
So what signifies wishing and hoping for better times? We may make these times better, if we bestir ourselves. Industry need not wish, and he that lives upon hopes will die fasting. There are no gains without pains.
Growth and gains come at a price through pain. The phrase “no pain, no gain” appears in many contexts, but above all in the realm of fitness.
In her book Unbroken about World War II prisoner of war (POW) Louis Zamperini, Laura Hillenbrand illustrates the remarkable growth that can accompany a willingness to embrace discomfort. Zamperini was born in America to Italian immigrants. As a boy, he was bullied and mocked for his English, so his father taught him how to box. Training in the ring with his dad involved a lot of discomfort and pain, but Zamperini wanted the bullying to stop, so he pushed through it and eventually began to defend himself successfully.
Zamperini’s older brother, Pete, encouraged Louis to start running track. To keep pace, Pete would run behind him and hit him with a switch if he slowed down. Pretty soon, Zamperini was breaking records. A naturally gifted runner, he went on to compete in the 1936 Olympics.
In 1938, Zamperini competed in the mile while at USC. Other runners singled out the Olympian in their midst for abuse, spiking him with the sharp edges of their shoes to hurt him and slow him down. Determined, Zamperini pushed through the pain to set a new record for the national collegiate mile: 4 minutes, 8 seconds.
Without pain or the fear of more pain driving him, Zamperini would never have achieved his amazing potential. Without achieving that potential, he never would have survived the challenges to come.
In 1941, Zamperini joined the Air Force to fight in the Second World War. His plane was shot down over the Pacific and he was captured by the Japanese after a long and arduous 47 days at sea in a raft. Near starvation, Zamperini was put into a POW camp, where he was beaten and tortured. At one point, he was forced to hold a steel beam over his head. Though weakened and pushed to his physical limits, he defied his captors by not succumbing to the pain.
After the war, Zamperini returned home, suffering from nightmares and what we might today call post-traumatic stress disorder (PTSD). He became an alcoholic, descending deeper and deeper into psychological pain. Eventually, however, Zamperini overcame the psychological trauma and alcoholism through a spiritual transformation. He became a Christian evangelist, forgiving his captors. Some of them even converted to Christianity after being embraced by their former prisoner. In a way, Zamperini’s remarkable resilience delivered a hopeful lesson to others about easing their own pain.
Pain is a metaphor that we can all relate to—it is especially valuable when it helps us remember a significant event, such as childbirth. Pain brings home the poignancy of the key events of our lives. Without pain, we would not appreciate the limits of our bodies and rally behind those who seek to test those limits. People facing physical challenges could not know their body’s limits without pain. By enduring the discomfort, victory is sweeter. We can all learn to better ourselves, through the embodied wisdom in pain, to become more resilient when faced with life’s challenges.
Pushing Through the Pain
Medicine is an art as well as a science. When it comes to the care of patients with maladaptive pain, there is a great deal of art involved because the science of pain is still very much in its infancy. Pain is both crucial and complex, nothing to be treated lightly. We must embrace what it tells us, because avoiding it completely simply isn’t an option.
“So what do I do when I get the pain?” asks Bob, a patient with spinal stenosis. “Stop and sit down until it gets better, or push through it?” Spinal stenosis is a narrowing of a region of the spine. In the lumbar spine region, it causes lower back pain and numbness in the legs when you stand or walk too long. Sit down, and the pain usually resolves within minutes.
“This is anything but a no-pain, no-gain situation,” I tell him. “Let your pain tell you when to rest and when it’s okay to get up again.”
Physicians are notorious for tolerating discomfort many others would not as they undergo the rigorous training and punishing hours of medical school, residencies, and beyond. How are we supposed to know when a patient is on the right path when we are treating their pain? Do we draw an arbitrary line somewhere in the sand?
In When Breath Becomes Air, Paul Kalanithi relates the pain he experienced from stage IV lung cancer, and how he pushed through that pain to complete his rigorous neurosurgical training at Stanford.
Though he was rapidly coming face to face with his own mortality, his desire to complete the path he was on was stronger than the pain, simple as that. Kalanithi’s book is a beautiful account of pain faced and overcome. Pain makes us present to our lives in a way that would not be possible without it. One passage illustrates the remarkable relationship between pain, suffering, and meaning:
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