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Chronic Pain

By: | Tags: | Comments: 0 | September 15th, 2019

Pain can be a tricky, misleading and frustrating problem to have. People who suffer from chronic pain have usually been through the ringer when it comes to looking for treatments. In this post we’ll discuss what pain is, how it can become chronic and how physiotherapy can help.


What is pain and how does it work?

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.  Not only can pain be caused by physical tissue damage (like a broken bone, cut on the skin, torn cartilage, etc), but it can also occur if your brain believes you are doing something that has the chance of causing damage. This is where the trickiness and frustration come into play.


To understand this concept, you must understand how pain works within our brains and bodies. The nerves in your body tissues (i.e. muscle, tendon, bone, skin) will send a warning signal to the brain and the brain will decide if it responds by sending painful signals to that same tissue. Because every person in the world is unique, your brain and body will respond differently to these signals compared to everyone else – some brains may not perceive a pinch, punch or squeeze as painful while others might: this is what most people refer to as pain tolerance.


What factors influence pain?

There are several reasons why everyone experiences pain differently, why some people can easily ignore it and continue on with their lives and others have a lot more difficulty doing so. Current research tells us there are 3 major factors that affect how a person experiences their pain:

– The type and amount of damage that is done to your body. For example, a deep cut in the skin will hurt more than a shallow one. A severe ankle sprain will hurt more than a minor one.

– Your mental health. Studies have shown that depression and anxiety are linked to slower recovery and more pain after surgeries such as knee replacements. Injuries which occur during psychologically damaging events can severely influence pain as well. Take a person who ends up with a minor neck injury after a car accident; They may recover very differently if, say, they lost the life of someone close to them during that same accident.

– Social support. If you are unable to walk for a while because you had surgery on your ankle, but you live with family who can help you get around and you are still able go through your normal daily routine, your perceived levels of pain can be very different to those of someone living alone and who had lost the ability to drive themselves to work and socialise.


What is Chronic Pain?

Chronic pain is officially defined as pain that lasts longer than 3 months. It can also be defined as “central sensitisation” which means your central nervous system (brain and spinal cord) have become overly sensitive to those warning signals we talked about earlier. Your tissues may be sending very minor warning signals or none at all but the brain responds with sending painful signals to that area. It may get to the point where the brain begins sending severe painful signals in response to a light touch to the skin in that area, or a small movement of the painful joint. This can create fear of movement which can lead to stiffness and weakness, which in turn can lead to further painful signals. It is possible to take control of this cycle and reverse it by improving mobility and strength.


Although chronic pain is often associated with conditions such as chronic low back pain, TMJ disorder, whiplash, rheumatoid arthritis, osteoarthritis and fibromyalgia, it is important to note that if you’ve been diagnosed with one of these conditions it doesn’t necessarily mean you have chronic pain. Similarly, if you have chronic pain, it isn’t necessarily related to one of these conditions.


Is the pain all in my head?

After dealing with pain for months, years or even decades, we often seek answers in the form of MRIs, X-rays or even surgery. When there may not be answers or remedies with these routes you might begin to think the pain is all in your head. This is NOT the case. The pain you experience is 100% real but can be difficult to diagnose as it doesn’t show up on imaging techniques like X-rays or MRIs.


Tips for avoiding chronic pain

If you’ve had a recent surgery or injury to any part of your body, keep these points in mind to avoid your current pain turning into chronic pain.

  • Understand how pain works. Re-read the first section of this post and you are on your way to avoiding chronic pain.
  • Don’t focus on image results. It is human nature to want an explanation for why we hurt. Many professionals seek these answers in the form of x-rays, MRIs, CT scans etc. It has been shown over and over again that the results of these tests don’t generally explain the reason behind pain. In fact, certain results may lead to unnecessary surgeries and can contribute to the cycle of chronic pain.
  • Address your mental health throughout your care. If you experience depression or anxiety, you may want to speak to your doctor about ways to further manage these feelings before, during and after a surgery or an injury.
  • Keep an active lifestyle. Being afraid to move when you hurt is a natural response to pain – protecting the area that the brain believes to be injured is the most basic reason for why pain exists. This, however, is not always the path to recovery and healthy movement can help prevent your pain from becoming chronic.



Why see a physiotherapist for Chronic Pain?

One of the best ways to work around chronic pain is to decrease the sensitivity of the painful signals being sent by your brain. This begins with gentle stretches and exercises as a way of teaching your brain that although it hurts right now, these movements are not doing damage to your body. As a result, your brain will begin to quiet down those painful signals over time. It is important to take these initial steps with a qualified physiotherapist who understands how to help you make gradual progress without doing too much too soon. Your physio will help you to learn what your limits are now and how to work around them and continue to improve. It can take some time, but by the end of your course of physiotherapy you should have much more control over your pain and be on your way to an improved quality of life.