We have all experienced physical pain. It may have been from a needle, a cut or something more long-lasting like arthritis. After a bleed, there will always be some degree of pain. It is important to understand why bleeds hurt and how to best manage the pain that results.
It is hard to understand someone else’s pain because it is very personal. Even if you do not have visual signs of an injury like a bruised or swollen joint, you may still feel pain. But because the pain is not obvious, others around you may not understand how much pain you feel. Similarly, it is hard describing what your pain feels like to other people. It is like describing the taste of chocolate to someone who has never tasted chocolate before.
Experts believe there are many reasons why pain varies for different people. It can be affected by:
- your physiology, or the way your body is made up
- the way your body responds to physical and emotional stress
- your mood and beliefs
- the way parents and friends respond to you.
Why do bleeds hurt?
Pain is the body's warning system, alerting you that something is wrong. We have specialized nerve cells (neurons) inside our skin and other body tissues that tell us when to feel pain. Bleeding can trigger these pain neurons. The chemical signals travel through the nerves in our spinal cord up to the brain, where we interpret the signal as pain. Your bleeds may hurt for a short while (acute pain) or for a longer time (chronic pain).
Acute pain
With acute pain, you feel the pain right away, but it gradually goes away. Acute pain is usually caused by tissue damage or inflammation. It protects us from hurting ourselves. If we did not feel acute pain, we might burn our fingers on the stove or not know when we have a serious problem. Acute pain is sometimes called nociceptive pain.
This is the type of pain you feel when you start to bleed right away (acute bleeds). You may experience an acute bleed in a joint, which begins to hurt when blood starts irritating the lining of the joint (synovium). The pain gets worse as blood fills the joint, building pressure inside the joint.
Chronic pain
Chronic pain lasts for at least three months. Unlike acute pain, chronic pain does not act as a helpful warning sign when we’re experience something harmful. Often, acute joint bleeds trigger long-lasting changes inside the joint, causing chronic inflammation and pain. You can find more information about chronic pain in Module 5.
As you will learn in this section, pain management in hemophilia is truly a team effort:
- Your comprehensive care team (CCT) will discuss the medicines to help meet your specific needs.
- Your physiotherapist will help you develop a safe rehabilitation and exercise program.
- Your psychologist can help you find other ways to manage your pain, such as relaxation and distraction techniques.
