All of us have had experience with pain at some point in our lives, whether we had an injury, experienced a bad fall or suffer with occasional back spasms. For many of us, we feel immediate pain following the incident, but it begins to lessen as healing takes over before finally disappearing completely as we return to normal (usually somewhere between 3-6 months). While we feel frustrated when injury happens, we know it will pass soon. But what about when it doesn’t? This is the reality of many people with chronic pain.
What is pain?
Pain is a protective mechanism, a sort of public service announcement from your brain about a credible threat. If we did not experience pain, we could be potentially exposed to dangerous physical situations for damaging lengths of time. In the case of the pain of a burn, the message is simple: “Fire is super-duper dangerous! Don’t mess with it!” But does the message really need to be as loud as it is? Does it have to last for days, weeks, months or even years? Any type of pain, acute or chronic, is perceived in the nervous system. The pain sensation begins when the brain “decides” that the pain sensations are actually needed.
Therefore, tissue damage does not necessarily equal pain. A strained hamstring or sprained ligament does not create the pain you feel, the nervous system does. If the nervous system feels “safe” and decides pain is not needed, you might be carrying injuries without even knowing about them.
How can the nervous system get it so wrong?
Often times, patients with chronic pain conditions will perceive the simple touch of a feather on their skin to be excruciatingly painful. These same patients tend to be on high dosages of pain medications or steroids just to get through their day. The nervous system has a tremendous amount of plasticity (also known as “neuroplasticity”), which means it is constantly restructuring and adapting to experiences.
Which brings us to the important concept of nociception, which is defined as “the neural processes of encoding and processing noxious stimuli.” It is the afferent activity produced in the peripheral and central nervous system by stimuli that have the potential to damage tissue. This activity is initiated by nociceptors, (also called pain receptors), that can detect mechanical, thermal or chemical changes above a set threshold. Nociceptors are specific nerves which relay danger signals to the spinal cord and brain. Once the message reaches the skull, it is ultimately up to the brain to produce the output (a “what am I going to do with this “danger”? message”).
Many treatments focus on damaged tissue, such as physical therapy, acupuncture or chiropractic adjustments. They are all very valuable in terms of treating tissues & joints – but may not change the actual perception of pain in the brain. Therefore, we need to change the paradigm and begin to shift our focus towards taking care of our superbly sensitized nervous system instead of the only local tissue damage (that may or may not be there).
Come back on Friday to learn how to calm your nervous system and break the cycle of chronic pain!