Pain: What is it, how does it work and how do we help you overcome it!
Pain is something that can debilitate anyone throughout their life. Today let’s break down some of the key fundamentals of what pain is, how pain works and most importantly what you can do about pain!
First, I want you to picture stubbing your toe on the edge of your lounge.
Ouch! If a past experience came into your head, you may have a memory of jolting back, stopping every task, thought, emotion you had before, becoming completely aware of the sensation you just experienced in your poor toe.
Now the next question is, did you still feel pain from that memory? Maybe not the toe scenario specifically. Maybe you had an injury to your knee from sport or you broke a bone when you were little. Do you still feel some pain, tenderness, ill thought, protectiveness even around the injury?
If you answered yes, you aren’t alone. Many people actually suffer from pain long after an injury has passed.
How can this be though?
Well, there are a few key points I want you to understand straight off the bat.
- Pain is an in-built protective device
- Tissue damage and pain often do not relate
- The longer we have pain, the better our body (nervous system) becomes at producing pain.
- Pain is a by product of how much pain your brain ‘thinks’ you are in, not how much you are actually in.
Now each person is unique in how they will perceive, exhibit and think about their pain.
The first step for individuals or practitioners working with individuals is to figure out one’s pain beliefs.
Our belief, thoughts and feelings can be a huge implication for how we recover!
Did this surprise you?
This is now a widely and well documented area which gave birth to the biopsychosocial model. Basically, this is a model that views you in three main components and how they interact with one another.
Biological – such as breaking your arm and experiencing pain
Psychological – that is how you think and feel about your above broken arm, are you worried, anxious, depressed?
Social – that is how your relationships are affected by your injury. Are you unable to participate in group activities / sports like cricket now because you broke your arm – maybe you will feel isolated or have an imbalanced lifestyle.
If these factors aren’t viewed in a holistic manner – a broad approach that views how the injury, disease or pain itself is impacting you on multiple fronts, I hate to say it but the treatment you receive won’t be very effective.
In my experience this is largely an active process on your part. To truly heal from debilitating pain, you must take ownership of yourself, engage with the education being provided with you and implement the techniques, strategies over a period of time so you build resilience, mental fortitude and self-efficacy.
The people who fail to overcome their pain are often stuck in a cycle of seeing another health care provider who treats their symptoms such as a sore knee. These practitioners will often say the cause is one singular issue such as a muscle not working rather than a multi-factoral concoction of reasons that have lead to the appearance of pain.
Instead, a quality practitioner should improve pain in a person by:
- Treat the person not the symptom
- Build resilience
- Encourage continual movement (with modifications if need be)
- Promote health awareness
- Improve their movement capabilities
- Provide pain education about fear avoidance, resilience and self-efficacy
- Build rapport and trust with the person in front of them.
Ok let’s break this up with some fun facts:
- The entire brain (cells) is replaced every few weeks
- If no problems whatsoever exist in your body e.g., nerves, immune system, musculoskeletal system, you may still feel pain if your brain thinks you’re in danger
- Giraffes and Humans have the same number of neck vertebrae (bones)
Still with me?
A few key points keep popping up throughout this blog
- Pain is protective
- Tissue damage and pain do not have to match
- Pain can be heightened by how our brain is feeling in a given environment
Time to break it down!
Pain is protective:
How can this be? It hurts! Well pain is a signal albeit a relatively strong, in your face, look at me signal. It is ultimately here to protect us.
Pain prevents worse things from happening. Try and touch a hot stove, what does your body do? Jolt back from a sharp burst of pain. While this hurts acutely or for a short period of time, it avoids a long term or more serious injury such as 3rd degree burns from happening.
Tissue damage and pain do not have to match
This is one for the often-long term or chronic pain people. The average healing time for most tissue to heal is 3 months
Muscle – 2-4 weeks
Tendon – 4-6 weeks
Bone – 6-8 weeks
Ligaments – 12-52 weeks (complete strength)
So why is it that our pain can last years, decades even?
Tissue damage does not necessarily = pain.
Think back to our biopsychosocial model – if you are someone with pain that has lasted over 3 months, you are deemed someone with chronic pain.
Using the above model let’s create an example:
You had a disc bulge injury from picking up an object from the floor. Disc bulges typically heal themselves within 12 months of the injury, pain usually subsides within 3 months by itself. Now say you do still have pain and it’s now been 2 years since your injury, what gives?
Well even though from the biological side of things you are all good, there may be lingering, untreated areas of the psychological and social aspects.
Psychologically you may have told yourself that picking up that object caused your back to hurt so you now avoid picking up objects a certain way, or maybe you still pick them up but you brace yourself like your about to lift up a car.
This person is exhibiting fear avoidance and catastrophizing behaviour. These two terms mean you are thinking worst case scenario, scared that by lifting this object because of your past experience, you will again hurt your back.
Enter the social side, maybe you don’t go bowling with your friends anymore because you don’t want to pick up a bowling ball, or maybe you have limited other social activities because of the fear of hurting your back again. This will now lead to feelings of isolation and being separate.
How does this lead to pain? Well remember the key point that pain can be heightened by your brain?
If you are feeling unsafe, alone and helpless in an environment your brain can become hypersensitive to normal sensations. This can lead to feelings of pain – sharp or dull aches even though there isn’t actually any physical damage there.
This isn’t to say your pain isn’t real. Your mind is powerful, you think it, it’s real!
As I mentioned earlier, to improve upon this you must break out of this vicious cycle of despair and helplessness.
You aren’t alone in your treatment, however you are the one who has to actually engage with the treatment for it too work.
- Look into gradually exposing yourself into different movement patterns again e.g. learning to pick things up from modified distances until you become comfortable.
- Continue learning about pain – what it is, how it’s produced.
- Check out this great Ted Talk that gives a snapshot of pain science – TEDxAdelaide – Lorimer Moseley – Why Things Hurt – YouTube
- Get moving – start gentle e.g. walking and build your confidence!
- Appreciate how adaptive we are as humans. Our brains are plastic meaning we can alter – learn and unlearn negative thoughts and feelings.
- Be patient and kind to yourself – This isn’t easy, it will take time and a lot of hard work. But with the right support network you can become free of pain!
Each of these things can be done by a quality practitioner, if you feel you need help with overcoming pain, wanting to move more and be free to do the things you love again. Move Right EP can help you.
Reach out today at firstname.lastname@example.org