Updated: Jun 23
Do you have "Chronic" pain??
Take a second to understand what might be going on with your body and the different factors that play into the pain we experience!
I think the word “chronic” in reference to pain has developed a negative connotation, a sense of dread, permanence, and helplessness. It also only encompasses the timeline of one’s pain rather than the complex and interconnected experience of their pain.
Language matters, thus I say “complex” pain and will for the rest of this post!
The following are all factors that play into one’s experience of pain:
Our knowledge about pain and beliefs about our bodies (personally and culturally)
Our past experiences with pain
How we have learned to cope with pain
Where we are physically and who we are with when we experience the pain
When: Both small scale; time of day, week or month, or large scale; where in our lives we are when we experience the pain
Stress/anxiety/depression: AKA the state of our Central Nervous System (CNS)
Sleep/nutrition/hydration: AKA our physical health, and thus the state of our CNS
Actual tissue damage
How long one has been experiencing the pain
What is Pain?
Pain is an output, or alarm, of the Central Nervous System (CNS) in response to ACTUAL OR POTENTIAL tissue damage.
Pain does NOT EQUAL tissue damage, pheuf!!!
We are lucky that it is so, and lucky that our bodies have developed these amazing ways of protecting us. These adaptations also have the potential to become maladaptive.
We have many receptors in our fingers that detect tissue damage, mechanical pressure, temperature, vibration, texture, stretch, position in space, and more. If I pet my dog, each of these receptors will detect their respective stimuli and send that information to my brain. My brain will integrate this along with all the other factors listed above, and decide whether the stimuli is a threat. I have never felt pain while petting my dog so I think my brain knows my dog is safe, there is no pain response.
If I reach to pet another dog and that dog bites my hand, pressure receptors will send information on the deep pressure of the dogs’ teeth, proprioceptors will send information on where my hand is in space, and nociceptors will send information on whether there is ACUTAL OR POTENTIAL tissue damage. The brain uses its same method of integration and interpretation and decides that there is a threat, therefore it produces a pain response. Cue the alarm, I feel pain.
SO, the body doesn’t signal pain to the brain, the brain signals pain to the body.
Aforementioned angel with fur, Nelly
Sensitivity and the CNS
When we experience prolonged pain or remain in a state of stress and anxiety, when we don’t get sleep or nutritious foods, our CNS has reason to believe there is danger so it changes to protect us. It ups the sensitivity on its alarm system, meaning it will send pain signals more often when there isn’t actually tissue damage. It is being overprotective because it is in a state of fight or flight.
Some people have experiences early in life that have sensitized their nervous system to stimuli of all sorts. The timing of major or traumatic life events can coincide with the development of new or increased pain and symptoms. The nervous system gets very adaptive at slipping into, or further into, a state of “fight or flight” and further away from “rest and digest.” As someone experiences pain overtime they begin to form beliefs about the pain. Beliefs influence actions and they stop moving out of fear, this is fuel for pain.
So what then?
The good news!! In order to take control of complex pain, a HUGE first step is understanding how pain works and then applying that to one’s own experience.
Here are a few other small things you can try, because many small things make a big thing:
Figure out what impacts the pain, be mindful of what you have been doing physically, feeling emotionally, and what has been going on in your life when you are experiencing greater pain than usual
Move in ANY way shape or form that you can, within pain, not past it.
Evaluate how you cope with pain, and it's efficacy
Value sleep, it matters!!! The research resoundingly supports the link between reduced sleep and negative effects on pain.¹
Use your breath to let your nervous system know that it is safe, try box breathing! Inhale for 4s, hold for 4s, exhale for 4s, hold for 4s, repeat for 5-10 minutes/day.
If you would like information or guidance past these initial steps, contact us today to book your physiotherapy treatment at our Edmonton clinic!
Interested in additional services to help with complex pain?
1-Afolalu EF, Ramlee F, Tang NKY. Effects of sleep changes on pain-related health outcomes in the general population: A systematic review of longitudinal studies with exploratory meta-analysis. Sleep Med Rev. 2018;39:82-97. doi:10.1016/j.smrv.2017.08.001