Pediatric Occupational Therapy

Why do some people not register pain the same as others?

Therapist st clair shores

Touch, or tactile input, is one of the body’s senses and it is how we register physical feeling. Pain is defined in the Oxford dictionary as “a physical suffering or discomfort caused by illness or injury”. Typically, when someone registers touch at a normal rate, pain will register when they get hurt or are feeling sick. However, when someone has sensory processing difficulties, they may not register it the same or even at all.

There are instances where light touch can be registered as pain while deep touch input isn’t registered whatsoever. What does that look like? Think of it as big pain (deep touch) such as bumping or running into something or even breaking a bone may not be felt by the person at all while being brushed lightly by the dog walking by or the feel of certain clothing can result in tears.

By not registering touch typically it can impact someone’s safety. You may be asking yourself how it impacts safety? Well, the person can become easily burned by not being able to tell when something is hot or not being able to tolerate whether appropriate clothing can result in sickness. Another way is not registering when they get a cut in their skin as this can result in infection or having a broken bone can result in it being set wrong. So, it is very important to help the person be able to work towards recognizing pain and the safety awareness associated with it.

If you or someone you know has abnormal responses like these to touch, they may be suffering from sensory difficulties. If that is the case, you should speak to your physician about it and bring up occupational therapy for sensory integration therapy. Why? These specialized therapists work on helping the body improve its registration of touch to make the body more aware of when a person under-registers it as well as improving the tolerance when a person is more sensitive to touch.

For children, this is done through play because that is the main occupation of a child. This may look like sliding down a foam wedge covered in shaving cream or riding a zipline to land into a large lycra swing. Each of these activities works on providing deep pressure and light touch simultaneously. The shaving cream and climbing in the lycra are lighter in touch while the sliding and the landing give more deep pressure. Now, there are many activities that can work on tactile tolerance, these are just two examples.

When working with adults, treatment can still be fun but look a bit differently. For instance, our occupational therapists will also use shaving cream but it may be by putting it on a wall to draw in while standing on an oscillation table (the back-and-forth movement of the table is regulating). Lycra is also used with our adults in the form of sitting or lying inside while it cocoons around the client and then uses a rope to propel the swing back and forth as a regulation tool. Our therapists can also approach touch in another way by using weighted blankets while providing manual therapies like craniosacral therapy or lymphatic drainage to improve tactile tolerance of light touch. As the body has to work on improving deep touch before it can work on light touch tolerance, hence the use of the weighted blanket in combination with light touch manual therapy.

If you have any questions about Sensory Integration or have a topic you’d like us to write on, please reach out because we want to hear from you! In the meantime, go forth and flourish!

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