In this post we discuss why you might feel less pain when on holiday.
Take a look at the picture above, how does it make you feel?
If you don’t like the heat perhaps not great. But for many of us, particularly those who suffer long and hard winters, pretty good I imagine.
For years I’ve noticed that people who suffer with chronic pain and injury usually feel better when they go on holiday.
The more we understand about pain, the more this begins to make sense.
Pain is contextual
How much pain we feel depends not only on our general health but also our environment.
Change that and pain can markedly reduce.
Now of course we can’t spend our days on holiday, but this effect can be used as a tool to educate us on the nature of pain.
Perhaps you slept better whilst away, ate differently, or spent more time with your family or friends.
You may have also been in nature, experienced more sun exposure and been more physically active. These are all things that can influence pain and can be recreated back at home.
Contextual factors and treatment effectiveness
The contextual element of pain can also be used to make treatment more effective and can give you a clue as to why some treatments didn’t work.
I’m sure you’ve had the experience of speaking to a medical professional and thinking they weren’t really listening to you.
Perhaps they were dismissive or seemed distracted. Either way you knew this person wasn’t going to help you. And of course they didn’t.
How about walking into a practice or a gym and noticing an unpleasant smell, or that the toilets were dirty?
Perhaps you saw another patient in pain, or the lighting seemed dim and oppressive. Maybe the receptionist was unfriendly, or the music was too loud or inappropriate.
These are all cues that may themselves cause your pain to become worse, or nullify any effect the treatment or exercise may have.
Research into this area provides fascinating reading.
A study published in the Annals of the Rheumatic Diseases showed that 75% of the overall treatment effect in osteoarthritis is attributable to contextual factors, rather than the specific effect of any treatment.
A meta-analysis on spinal manual therapies showed that in acute pain and chronic pain respectively, 81% and 66% of the pain variance were ascribed to contextual factors.
How to make contextual factors work for you
Understanding that contextual factors can influence pain can motivate you to make changes that might help you feel better.
Recreating some of the factors that benefited you whilst away, such as prioritising relationships or spending more time outdoors, can help you bring those benefits back home.
Knowing that contextual factors are important to the effectiveness of treatments, can also help you assess what feels right to you and will likely help you feel better.