People in pain are treated by our physiotherapists on a daily basis. For the everyday person, pain is something we have all felt at some point in our lives, and is an extremely complex phenomenon that impacts people in various ways.
Perhaps it is something that comes and goes in your life and is only temporary, or maybe it’s something that hangs around and won’t go away. Maybe it is something that prevents you from doing many of the things you use to enjoy? When pain persists for longer than three months, it falls into the category of chronic pain.
Thankfully there have been some amazing advances in understanding how it works, why we feel pain and why it may persist. Some of the keys points that have emerged from modern research is that pain is not a signal or sensation that is sent from the body to our brain, on the contrary – it is sent to our body from the brain as a means of protecting the body.
Are you saying it’s all in my head?
The answer in a word is NO! The experience of pain is felt in your body; however is being driven from our brain. At the end of the day, the brain is the boss, the CEO, or Prime Minister, whichever way you want to put it – the brain controls our experience of pain.
How does that work?
It begins with the nerves in the periphery of our body being triggered by a threatening stimulus (think of the time you stubbed your toe on the bed post). These nerves in the periphery of the body are called nociceptors which send the danger signal up to the brain. Once the brain receives the danger signal, it then interprets the information from the danger signal. If the brain concludes that the threat of this danger signal is legitimate, it will respond by sending pain to the body as a means of protecting ourselves.
Why does pain hang around for so long?
Like anything, the more we do it, the better we get at it. Therefore if these danger signals in our body are continuously sending these messages up to the brain, then they are going to get trigger-happy and send these danger messages up to the brain for very minor things. Think of it as a car alarm. We would hope that our car alarm goes off before the burglar has completely broken into our car to steal it, just like our brain will often send pain to our body before we do any serious damage. However when it falls into the chronic pain category, it is like the car alarm starting to go off all the time for minor or unnecessary things like when someone walks past our car, or it goes off in the middle of the night for some reason you may not even know (seriously, how annoying does that sound!?). So when this occurs, we have a problem in the nervous system rather than in our body’s tissue such as our muscles, tendons, ligaments and joints.
So, where to from here?
Whilst it may only be a small step, it is an important one to know that the experience of pain is a result of the brain trying to protect our body and is not always an indicator of damage to our bodies. Over time when pain persists our brain can be over protective, just like that over reactive car alarm that keeps going off but doesn’t mean that there is a burglar trying to break in! Knowing this small but very important information is part of the educational therapy. However it is just the beginning of the journey!