What is pain and how does it work?
Pain is a necessary protective mechanism, our own alarm system. It is ok to feel pain.
You learn pain – it’s an adaptation of the nervous system based on context and past experiences. You feel the hurt in the tissues but the problem is in the nervous system, and this we can retrain.
Pain is a complex output. There are no nerves that are responsible for causing pain, but the nerves send messages to the brain (nociception), which decides what to do with that information.
Pain is a subjective experience, influenced by memories and emotional, pathologic, genetic and cognitive factors.
The brain decides ‘what would be advantageous for me right now? Is this dangerous?’ It decides if there is a need for a pain experience.
Pain often stops even before tissues are fully healed. The pain is gone because you no longer need to protect the area. It is not an indication of tissue damage. The brain responds to what it THINKS is happening in the tissues.
Think of the nervous system as a complex alarm system – even the simple alarms we have in day to day life malfunction time to time – e.g. sensitive car alarm always going off!
Is pain easy to understand?
In a word, no!
It is acceptable and safe to feel pain. It is good to be in pain, just not to stay in pain.
Some people can have low back disc issues and not feel any pain. Also, structural changes are common as we age, but that does not mean a pain response is initiated.
It is possible to cause pain without damage e.g. pinch ear until it hurts – no damage is done, but the pain is the brain asking you to stop before damage does occur. With increased sensitivity, pain can be caused unrelated to tissue damage.
The immune and nervous system can get very good at producing pain. Nerves become better at things the more they repeat it, like how driving a car becomes almost automatic to us.
The alarm system is doing its job, it’s just doing it too well!
Recent advances in neuroimaging can show how emotional and cognitive influences such as hypervigilance, catastrophizing, anxiety and depression can all influence an individual’s pain perception.
Is it all in my head?
No. You don’t just think it hurts, it hurts!
All pain is always real, no matter what is causing it.
It’s the brain that constructs the response based on numerous factors – it is not a conscious construct – e.g. think blushing.
Pain is fundamentally dependent on meaning, and the significance you attribute to it. The brain will assess the risk/benefit ratio.
How can I explain my pain?
However you want. Pain is individual to each one of us. It is unique and based on many factors.
People talk about high/low pain thresholds, but it is only down to how you experience the pain and it cannot be compared.
It is said that pain sits outside of language and cannot be explained to the extent we wish.
How will therapy help me?
To feel that it is safe to move, to exercise gradually into pain, which aims to reduce the overall sensitivity of the nervous system. Hurt does not equal harm.
To move focus away from pain and towards function and the goals you want to return to.
To take advantage of ‘neuroplasticity’ – we can repeatedly do things and movements that rewire the brain.
To understand that pain is complex.
To relax! If you’re apprehensive and expect it to hurt, it will. De-threaten the pain. Pain is an ideal habitat for worry to flourish.
To be aware of how you hold yourself and how you move – pain thoughts lead to pain behaviour.
To accept and commit to therapy – it can take time. Set yourself short and long term goals, not just to be pain-free immediately.
To relax and use breathing techniques. Stress is the brain sending signals for you to take necessary and needed action and once you have, it can stop sending those signals and cease the alarm. If stress becomes unmanageable the brain forces you to act and it will keep turning up the volume until you do.
Pain education is a cognitive behavioural intervention that provides insight into pain neurophysiology to help alter maladaptive pain reasoning and beliefs about pain.
Call us on 020 8977 3295 to speak to Vikki Bradley, Rehabilitation & Sports Massage Therapist, or to one of our other practitioners.
“If you listen to the body when it whispers you don’t have to hear it scream”
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