Pain - Part 4 - Nail through the foot

The Neighbourhood Clinic was established to provide excellence in healthcare to our local community. Part of that role we see is sharing important clinical and scientific messages. Pain is a condition that is rife in our society and there is so much misinformation about what it is and how it works that we thought this series may help to be part of the solution.

For many of us we tend to think that pain is relative to tissue damage. Break an arm, lots of pain. Pinch a nerve, lots of pain. But what about when you stub your toe? Lots of pain, but within 20 steps the pain is gone? Is that related to tissue damage?

Or what about this very famous case study from the British Medical Journal in 1995:

A person steps off a ladder onto nail. Screeching amounts of pain ensues as the person can see the nail has pierced their foot and boot.

Rather than pull the boot/foot off the person is carefully taken to hospital with the boot and foot still attached via the nail to the plank of wood.

Still in lots of pain, the patient is given super strong painkillers to cope with the ride.

When they get to the hospital the patient is not coping very well but it only gets worse for them. The medico's gently slice open the boot only to find that the nail has gone between the shrieking person's toes.

Why? Because pain is multi-factorial. It is not just based on tissue damage but rather than on the brain's best guess at risk.

How should you manage pain such that you are able to do the things you want to do? See a GP, or an Osteo, or an EP, or a Psychologist, or an Acupuncturist, that knows how and what pain is.

The Neighbourhood Clinic: Clinical Excellence and Clinical Education Layered with Empathy and Humanness