Many of us know someone who suffers from a chronic pain condition. Persistent pain can significantly reduce an individual’s quality of life by holding them back from daily activities, negatively impacting their mood and relationships, or leading them to feel helpless. Not only does it place a large burden on that individual, it also affects our healthcare system.
Conditions commonly associated with chronic pain include:
- Lower back pain
- Upper back pain
- Neck pain
- Shoulder pain
I’d like to educate our readers about pain – the different types and actions you can implement to help you cope.
Pain is an incredibly broad subject which can make it difficult to summarise, so I cannot promise this will be a short blog but please bear with me!
Let’s start with defining pain:
“Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage…” – World Health Organisation
From the definition above, pain is NOT an accurate indicator of tissue damage given it can be felt even with “potential tissue damage”. And this can be the case in sudden causes of pain as well as more long term pain situations. This leads us to the types of pain that exist: acute and chronic.
Acute pain serves to alert and protect the body of potential damage and usually has a sudden onset as a result of an incident. For example, imagine your house alarm sounding when it detects a robber has broken in through a window. How does it really work in the body? Receptors called nociceptors detect a potential harmful stimulus to the body, they send this message to the brain, the brain then processes this information and decides to act appropriately to protect the body. An acute pain response might be when you accidentally touch a flame – the brain processes this as harmful and quickly activates the muscles of the arm to retract the hand. No actual damage is done to the skin due to the “quick thinking” of the nervous system.
However in recent times, pain scientists have realised the sensation of pain is a lot more complex. They have identified through various studies that your nervous system can generate pain signals without the presence of harmful stimuli. It has also become apparent that there are many components that can affect an individual’s level of pain experienced, and that the intensity of pain felt does not necessarily correlate with the extent of an injury or tissue damage.
Pain intensity may be shaped by various factors including:
- Previous experiences
- Beliefs associated with the cause of your pain
- Impact you believe it is having on your life
- Likelihood of recovery
This is not often related to the threat of tissue damage, and is classed as pain persisting beyond the expected healing time of an injury. Suffering long term, chronic pain can actually lead to structural reorganisation and functional changes in our brain!
These changes may alter the pathways involved in sensing pain, emotional processing and mechanisms that would normally act to reduce pain. Our nervous system that detects pain becomes overly sensitive, may now respond to minor stimuli that are not normally painful and pain may also become more widespread.
If we go back to our house alarm, it is now easily triggered to minor events. For example, a person walking by or a dog barking may sound the alarm. This goes on and on, and both you and your neighbours start to become frustrated, confused, tired and cannot find a solution.
What Actions Can I Implement To Improve My Chronic Pain???
- Education – Improve your knowledge of pain and the condition you are experiencing from reliable sources.
- Improve coping strategies – This may involve consulting with other health professionals such as a an Osteopath, a pain specialist or psychologist to develop methods of managing pain and discuss the impact it is having on your day to day life. It is important to note, 30-50% of those experiencing chronic pain also have depression!
Lifestyle factors – Maintain adequate sleep routines, consume a nourishing diet and don’t forget to exercise! If a movement causes some discomfort, it does not mean you are causing further injury (remember – pain is not associated with tissue damage!). In fact, the worst thing an individual can do is to remain rested as this is associated with poorer outcomes.
- Stress management
- Reduce fear associated with pain
- Graded exposure to activities that would normally aggravate. Understand that our bodies are strong and designed to move!
- You do not always need to undertake further investigations such as medical imaging. Sometimes x-rays/CT’s/MRI’s can be helpful, however some findings are also identified in those who are asymptomatic so may not give any extra information on your condition.
- Discuss with your GP other options to manage pain in place of heavy medications
- DO NOT CATASTROPHISE! Poorer outcomes have been associated with those who put strict limitations on themselves due to pain, or believe their pain will never get better.
I hope you have found this blog helpful. If you or someone you know is suffering from chronic pain, pain scientist Lorimer Moseley has created this short video that is very informative: https://www.tamethebeast.org/#tame-the-beast