Pain is normal, personal and real, and although unpleasant, it can be understood and managed effectively.

There has been and still currently is, a paradigm shift in managing pain through influences of scientific research and developments in neurosciences. This has led a biopsychosocial which includes focuses on biological, psychological and sociological domains rather than looking for a single cause of pain (biomedical model).

It is said that knowledge is power. With the knowledge that pain is more than just a single cause, healthcare providers are better equipped to provide effective pain management intervention. Some tools that are commonly used in pain management are identifying pain triggers known as DIMS and SIMS. DIMS stand for Dangers In Me (negative) and SIMS is Safety In Me (positive). Some examples of DIMS and SIMS triggers are:

  1. Things you hear, see, smell, taste, and touch
  2. Things you do
  3. Things you say
  4. Things you think and believe
  5. Places you go
  6. People in your life
  7. Things happening in your body

A specific example of a DIM may be when you drive past an intersection where you had an accident, and pain is felt in the arm where you sustained a fracture in the accident. An example of a SIM is when you feel the warm sun touch your face, resulting in feelings of calm and happiness.

The ultimate goal is to identify what your brain interprets as danger verse safety. The challenge is then to weaken or remove DIMs and find or power up SIMs. The body tells the brain when it’s in danger, not when it’s in pain. Ultimately the brain is boss – it doesn’t have to listen to danger messages and may contribute to the pain you feel. It can take time to identify DIMs and SIMs and that’s where your healthcare team can help you work through the process and map out an appropriate treatment plan.

Pain is not a single cause. It is often a complex part of the bigger picture. Understanding what triggers your pain will empower you to be in control and manage your pain effectively.

Louise Roantree, Certified Hand Therapist, Physiotherapist