UNDERSTANDING PERSISTENT PAIN

12 Dec 2016


 

  • Understanding the mechanisms of your pain experience can be a powerful piece of knowledge. It is commonly thought that pain is always the result of some level of tissue damage, however, this is untrue. The 2 most important factors to start resolving your pain are; education and graduated exercises.
  • Think of pain as the danger alarm system.

 

THE MECHANISM (ALARM SYSTEM)

 

  • There are many sensory receptors in your skin, muscle and joints. These sensors all pick up different stimulus. Some sense temperature change, some pressure change, some are stretch receptors and some are movement receptors amongst others. These sensors are working all the time, every second of the day.
  • The receptors pick up various stimulus and send their signals to the spinal cord. If the information being sent to the spinal cord is high enough the sensation will be sent up to the brain. If there is not enough information being sent it will dissolve at the spinal cord and you will not feel any sensation.
  • If the information reaches the brain it is sent to multiple areas within brain. If this information is then deemed as a danger to the body the brain will make an executive decision to produce pain.
  • Therefor pain is an output of the brain as opposed to it purely being an input.

 

 

 

  • The brain determines if something is painful or not. If the brain perceives the body is in some sort of danger it will create a pain response. This pain response evokes action. Think of a time when you may have sat at a computer for too long without moving. The brain will pick up increased levels of lactic acid and other chemicals within the muscles and feel as though this may be of danger, as such it will evoke a pain response to force you to move out of that position.
  • Interestingly, pain levels vary depending on your situation at the time. For example, if you wake up in the middle of the night and stub your toe your pain experience will be different to if you stubbed your toe playing soccer. We have all heard those stories of people having significant injuries without experiencing pain. Think of a soldier being shot in war, sometimes they don’t know they have been shot. This is because it is more important for them to find safe ground than worry about a bullet wound (without obviously hitting vital organs) and thus the brain doesn’t evoke the pain response.
  • Pain is multifactorial, it is not only physical. Anxiety, sleep, previous painful experiences and beliefs all play an important role when the brain perceives pain.

 

 

 

 

PERSISTENT PAIN

 

  • All injuries have a similar healing process. There is usually a degree of inflammation at the site of injury which can provoke pain and discomfort, the inflammation starts the healing response and a scar is formed (think of the healing process after you cut your hand). Once the inflammation subsides and the healing is underway pain usually starts to reduce. However, in some cases (like chronic pain) the pain response stays well after the inflammation and healing has subsided. In these scenarios, the brain still perceives danger at the site of injury even though it has healed. The trick is to find out why.

 

 

  • Usually the brain has lost ‘confidence’ in the injured region and thus constantly thinks there is danger to this area. The two most important factors when resolving persistent back pain are education and graduated exercise.
  • The brain has a ‘body map’ that tells it where our senses are coming from and over time as we experience persistent pain these areas become hypersensitive. Think of this like a sensitive car alarm. A light brush of the car may set off the car alarm, even if there is no danger to the vehicle. This is the same for people struggling with persistent pain. This means that although we may experience higher pain levels at times it does not necessarily equate to the level of tissue damage.

 

TAKING ACTION

 

  • As mentioned before the first step is education, understanding how pain works and how the brain can sometimes misinterpret situations that shouldn’t be painful as painful.
  • Know what triggers your pain, this may not necessarily be mechanical triggers such as bending, it can often be related to current mood, sleep deprivation, nutrition/hydration and stress.
  • Retrain your body to move again. The brain loses ‘confidence’ in painful areas and a great way to restore this confidence is by moving and exercising in a way that doesn’t cause moderate to high levels of pain. Sometimes this will need to be guided by your chiropractor but sometimes it is as easy as going for a 10 minute walk once a day or spending sometime in the swimming pool.
  • Know that your brain is plastic and it is capable of amazing change. There is always hope and with the right guidance and a positive outlook you can return to doing what you love.

 

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