Introduction
to Pain Science
Understanding
your pain
Pain can be debilitating. Chronic pain brings 30 million people to the
doctor yearly in the U.S. 50% of those
in pain are unexplained. In other
words, the doctor agrees it is chronic pain but MRI’s, blood work, tests, or
x-rays don’t show a cause for the pain, which brings us to the topic of pain
and your brain. Pain science has become
increasingly popular in the manual therapy world. A whole new way of approaching pain comes to
light as more research and publishing’s on the topic arise.
Pain is weird.
Pain is not caused by any ONE thing.
We need to stop thinking of pain in terms of a single cause, “It’s all
coming from the knee surgery" (or you fill the blank). Pain is not a reliable sign of what’s really
going on. Chronic pain is a bag of
different factors, which are complex. Pain always has a layer of
brain-generated input, which can be helpful but also hindering. In the worst cases, the pain system can malfunction
in several remarkable ways, causing pain that is much more intense than just a
symptom. Sometimes, for many people pain is the problem.
- When pain persists, the danger alarm system becomes more sensitive
From an early age we are taught that pain signals are
a protective mechanism our body gives so we stop doing whatever is causing the
pain. This is easy to grasp if we’ve
broken a bone or touched a hot stove.
It’s not so easy to understand when a person’s body is giving them pain
and doctors can’t find anything wrong.
Or physiologically the bone is completely healed and therefore should
not cause pain anymore. But pain is not FAIR.
It is a product of: tissue damage, perceived threat and personal
history. Pain can occur without
identifiable tissue damage or it can outlive recovery so that even where tissue
has healed, the pain persists. For those
in chronic pain, this becomes a self-sustaining pattern. When pain persists, the danger alarm system
in the brain becomes more sensitive.
When the alarm system becomes more sensitive you feel pain more because
the body’s response systems and your thoughts and beliefs contribute to the
problem.
· Pain
doesn’t always match tissue damage
Dr. Lorimer Moseley tells an entertaining story of a
snake bite on his TED talk “Why things hurt” which illustrates pain can be an
illusion and personal history has a big part in pain. In this story he was walking along a trail
and felt a scratch on his left leg near the ankle and thinking nothing of it,
keeps walking. It turned out it was a
snake bite and he almost died. Years
later while walking in the same type of environment he felt a scratch on his left
leg near the ankle where excruciating pain immediately ensued. That time it really was just a stick that
scratched his leg but his brain was telling him, “remember last time you felt
this you almost died, this is an emergency!”
This example shows pain you perceive doesn’t always match the amount of
seriousness or tissue damage. When
something happens to our body, receptors send a signal to our brain to say
“something just happened.” Within
seconds the brain decides for us if we should be worried about it based partially
on past experience.
· Once
a danger message arrives at the brain, it has to answer a very important
question: “How dangerous is this really?” In order to respond, the brain draws
on every piece of credible information — previous exposure, cultural
influences, knowledge, other sensory cues — the list is endless.
Pain really
is in the mind, but not in the way you think, Moseley (TheConversation.com)
Everything in your body that hurts
involves a conversation between the central and peripheral nervous systems. I
love this example from Pain Science.
It could go like this:
NERVES
|
Got
problems here! Bad problems! Red alert!
|
BRAIN
|
Yeah?
Hmm. Okay, so noted. But you know what? I have access to information – sorry,
it’s classified but
It
suggests that we don’t have to worry about this much.
|
NERVES
|
I’m
telling you, this is serious!
|
BRAIN
|
Nope,
I don’t buy it.
|
NERVES
|
Look,
I may not have access to this “information” you’re always talking about, but
I know
tissue
damage, and I am not kidding around, this is a credible threat, and I am
going to
keep
telling you about it.
|
BRAIN
|
Actually,
you’re having trouble remembering what the problem is. You’re going to send
me fewer
messages
for a while. Also, these aren’t the droids you’re looking for.
|
NERVES
|
Uh,
right. What was I saying? Gosh, it seems like just a second ago I had something
important to say,
and it’s just gone. I’ll get back to you
later I guess …
|
I want to be very clear that this is not suggesting
the pain people feels is all in their head and isn’t real, rather by explaining
the way the brain works we can reassure people that the danger implied
by pain maybe exaggerated.
Many people with chronic pain want to “avoid pain”
so they don’t do the movements that cause pain.
If pain weren’t complicated this would be a good idea but as we’ve
discussed, pain has many areas involved so this approach isn’t the best and
leads to limited activity and less quality of life. For ideas of how to move with your pain
reference Lorimer Moseley’s book, Explain Pain.
In a nutshell, the idea is to retrain your brain that you are safe and
the movement is not causing you damage.
· Be kind to
your nervous system. Create pleasant, safe sensory
experiences — positive inputs. Seek comfort.
If your brain thinks you’re safe, pain goes down — and pleasure feels
safe. So be “nice” to your CNS in every way that you can think of.
· Don’t
be a pain drama queen. When you
exaggerate, talk about and dramatize your pain, you directly exacerbate the
neurological end of the chronic pain problem.
With a little education
and understanding why your pain won’t harm you, you can overcome pain and
return to doing the things you love by slowly adding smart activities to your
life. Be patient and purposeful in picking
activities which feel good and kind to your body and your brain will
follow. You can master this. The research shows that it works.
Contact us at: 619-917-4675 OR massagelamesa@gmail.com
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