# The Mathematics of Pain

Updated 1/1/2024

Throughout our lives, certain activities or interventions contribute to an increase or decrease in the pain we experience. To understand how these concepts relate to each other, try to think of them as terms or coefficients in a mathematical equation.

### The Equation

First, accept that in a chronic pain condition, there is always some degree of pain, “P.” In situations of myofascial pain, fibromyalgia, and chronic fatigue syndrome, this pain can be worsened by physical activity, “A;” changes in weather, “W;” posture, “P0;” and stress, “S.” So far, we can describe the pain as worsening with the relationship expressed with the following coefficients:

P = A + W + PO +S

To add to the equation, there are ways to reduce pain for people living with these chronic conditions. These pain mitigators include bodywork, “BW” (massage, chiropractic, physical therapy, myotherapy, trigger point injections); medication, “M;” nutrition, “N;” aerobic exercise, “AE;” and stretching and other home exercises, “ST.”

• Bodywork reduces pain by decreasing soft tissue pain input to the brain.
• Medication works by numbing the brain or healing the soft tissue.
• Nutrition is important because you get out of your body what you put into it.
• Aerobic exercise helps by increasing the margin of safety between physical activity and how much of this activity you must do without causing increased pain.
• Stretches and home exercises reduce pain by decreasing the pain input to the brain from the soft tissue.

Thus, this relationship is described as

P = A + W + PO + S – BW – M – N – AE – ST

### Applying the Equation

The more you expose your body to the factors increasing pain, the more factors you must add that decrease it. Ideally, the net result of the adding and subtracting should be a decrease or maintenance of P as close to 0 as possible.

As you live out each day, try to determine which activities are most important to you and which of the factors in the equation relate to these activities. Applying this equation lets you learn which factors to add or subtract to take better care of yourself and decrease your pain.

For example, suppose you experience increased pain when sitting on the bleachers at your child’s football game (A). Add to this your sitting posture (PO), stress (S), and the cold temperature outside (W). If you adopt a more nutritious diet (N), exercise to increase your level of conditioning (AE), and stretch out your body before you sit down on the bleachers (ST), you will be able to sit at the football game longer before your pain worsens.

The equation doesn’t just apply to the moments leading up to your activity, for example, sitting on the bleachers during the game. Stretching (ST) and bodywork (BW) after the game will reduce the pain that increases during the activity.

If you do not want your pain level to increase, you’ll need to achieve a better balance between the added and subtracted coefficients in the equation. Perhaps you can stretch more (ST), regularly condition your body (AE), eat better (N), or schedule massage sessions (BW). Over-the-counter pain relievers (M) can be helpful, but when they are the only active coefficient, the equation will be out of balance. As a result, your condition is not likely to improve but may deteriorate and your pain level may flare.