Are you experiencing pain?
Maybe you have had pain before, but this time is different. The pain is not going away and may even seem to be spreading. Activities you used to enjoy are sadly becoming impossible. The pain is wearing you down. You may have seen your medical doctor or orthopedist and prescribed medications, but the pain is not stopping. Leaving you with nothing but bills and more questions than answers.
This is the experience we hear each and every day in the clinic. We want to help give you some of those answers you are looking for by explaining how pain works and clearing up some misconceptions.
Pain science has made some big advancements in the last 10-15 years. Our understanding of how pain works has changed treatment techniques for the better. Unfortunately a lot of the “go to” treatments that are common in our medical system – like medications and injections – are not aimed at treating the right things.
Most people (medical professionals included) have the wrong understanding of pain.
We used to think very simply about pain. I touch a fire, this causes damage and subsequent pain. The pain signal travels up my arm to my brain. I feel the pain and move my arm away from the danger.
If pain could only happen in your body in this way, then how do we explain the heartache of loss? What about phantom limb pain?! This occurs when a limb is amputated but the individual continues to feel pain in the leg. If there is no leg to feel pain how could that happen?
All pain comes from your brain. Not from your body.
The truth is that pain is a signal created by your nervous system to warn of a threat. The threat can be due to real damage that is occurring, like your hand on a stove. Or it can be due to something that is not damaging you right now, but your nervous system sees as a threat.
In the case of the phantom limb, the nervous system is trying to figure out what is happening to the missing limb and feeling pain is a way to bring that area of the body to your attention. This does not mean that this persons pain is “in their head”, they are truly experiencing significant pain, but the leg isn’t to blame.
Your nervous system is in charge!
The nervous system actually chooses when and where to feel pain. Taking in sensory information from your body, comparing it to previous experience, analyzing the context and situation to decide if pain is warranted. It does all this quickly and automatically.
If you step on a nail in your garage it hurts. If you step on a nail trying to cross the street and a bus is coming, you likely won’t feel the pain until you get across the street and are safe on the sidewalk. Your brain decided not to share the information about that foot pain until you were safe.
Threat, Fear, Stress, and Emotional Upset
The brain is not very good at sorting out real tissue damage from fear and threat. In fact, being afraid or confused by your pain makes the pain more likely to get worse. Being emotionally or mentally stressed will also lower your pain threshold, making normally benign sensations get interpreted as painful.
You may wonder why some days the pain gets worse and others better, with little explanation. One reason may be stress. Carefully analyzing your life events surrounding the pain experience can help. If someone close to you passed away or you just lost your job, chances are that the pain will get worse.
Most people are now aware of the terrible addictive properties of opioid pain medications. These medications were commonly prescribed for pain but thankfully this is becoming less popular. The problem is that after the addiction to the medication sets in, your nervous system will try to find any excuse to keep the drugs coming. The stress of withdrawal combined with the belief that using the drug is justified when pain is present sets the stage for chronic pain. Ironically, using opioids for longer than 2-3 months can keep you in a chronic pain cycle.
Knowledge is Power Over Pain
Treating chronic pain is best accomplished through education. The best way to conquer fear is with understanding and experience – getting real answers to your real questions.
If your nervous system is all ramped up trying to protect you, the pain is going to continue. Learning about pain and understanding that feeling pain does not always mean there is damage will help your nervous system to calm. The pain will not go away until you take responsibility for it.
Many times getting out of a chronic pain state takes a village. Physical therapy can help by identifying if the pain is due to current tissue damage or if the pain seems like an over sensitive nervous system. In either case your pain is real. Either way, we are here to help guide you back to the life you lost to pain.
If you are trying to make positive changes in your life it helps to have some accountability. At peak potential we help our clients achieve health and vitality through physical therapy, wellness coaching and personal training. We treat our clients like family and look forward to welcoming you.
We would love to continue this conversation with you about your pain experience. Step one is getting your questions answered and we can do that for you from the comfort of your home. Click the link below to set up your free phone consultation with a Doctor of Physical Therapy today.
Written by Matthew Kahre DPT, ATC, COMT, CSCS
