Chronic Pain

Chronic Pain

Pain is NORMAL. It is the body’s way of alerting us to what it thinks is DANGER. The interesting thing about pain is that we don’t actually experience pain until our brain interprets a signal from the body as being pain. It is important to accept that YOUR PAIN IS REAL – IT IS NOT IN YOUR HEAD!! There are many things that contribute toward the brain signalling pain:  Thoughts  Fears  Past experiences  Family issues; My mother has cancer could this be what is happening to me?, Who will look after the family?  Work issues; Will I have to have time off? , How much money will I lose?  Anxiety/stress can increase the sensitivity of the nervous system  Exercise can help turn down pain signals by releasing chemicals that help to quieten the nervous system. All of these things make a difference as to whether or not your brain will interpret the signals from the body as pain. The important thing to understand is that the brain can still signal pain long after the original injury in the tissues has healed. When you initially have an injury, signals are sent to the brain to alert it to danger. The brain then interprets the signal, remember factors mentioned above will play a role in the brain interpreting the signal, and this is where the pain experience starts. This is all necessary so that you don’t go and do anything which may injure you further. However these messages can persist and lead to chronic pain.

Chronic pain is when you continue to experience pain long after the original injury has healed

This is due to central sensitisation. This is when the brain sends chemicals to the spinal cord to meet the signals coming from the tissues. These chemicals can be excitatory, which means they multiply the signals coming from the tissues and therefore send a much stronger signal to the brain then the original signal from the tissues. The brain can also send messages to the tissues to release more inflammatory substances – the body thinks it can heals faster this way, but doesn’t know when to turn off this inflammatory process. This type of inflammation is not helped by medication and explains why there can still be inflammation present many months later. This causes the nerves to become hypersensitive and send earlier and more signals to the brain, again this is an over sensitivity of the nervous system. Over time, the cycle continues which results in increasing sensitivity of the brain and therefore more and more pain. Pain can become a habit – your body anticipates and remembers it and it takes very little to trigger it, sometimes when things are really bad even thinking about moving can trigger the pain. The brain has lost its ability to differentiate between painful and non painful input, so just to be safe it triggers everything as pain. The brain has also lost its ability to distinguish between body parts so you may find your pain spreading or moving. The good news here is there is no damage in the tissues causing the pain, it is just that the brain is so used to feeling the pain that it continues to signal even though the damage has healed. It is the sensitivity of the nervous system that is causing this. The important things to understand is that PAIN DOES NOT EQUAL DAMAGE!! The solution is to make the brain understand that there is no longer any damage in the tissues and it is time to desensitise. We can do this through a graduated return to normal activity.

TAKE CONTROL

1. Any new injury or disease requires a prompt medical examination. 2. Understand any prescribed help. Ask for appropriate scientific evidence supporting what is offered to you. 3. Make goals that both you and your clinician understand. Aim for physical, social and work goals, which allow your progress to be measured.