When Pain Stops Protecting us

The vast majority of our patients see us because they’ve felt pain in one way or another. But, most people don’t realise that pain is 100% of the time an output from your brain.

Our brains receive information from the rest of our bodies (via our nervous system)

When we touch a hot stove it is pain that causes us to pull our hand away. For most people, most of the time, it’s a reliable communicator of the danger we are encountering. Pain tells us when and where our tissues have been damaged, letting us rest the area, protect it from damage and seek medical attention. If we tear a ligament or muscle, pain tells us to protect it.

How does acute pain turn into chronic pain?

Pain can also be inaccurate, especially in the case of chronic pain; typically pain that lasts more than 3 months. The degree of injury does not always equal the degree of pain. While pain that lasts longer than 3 months can be due to ongoing tissue damage, much chronic pain has little structural cause at all, even if it started out as a “normal” injury.

Sometimes the sensitivity in the neural system can remain even after the tissue has healed, especially if the injury has been ignored for too long or if its recovery was prolonged and difficult.

This over-sensitisation will often bring to light past pains or injuries, and cause patients to enter a cycle of despair. Pain leads to fear which can heighten neural sensitivity and lead to more pain. Your social environments and Psychological variables, such as depression and anxiety, can heighten this neural sensitivity, make your pain worse and influence a painful experience.

If your brain weighs up that there is a continuing threat, the pain process can become chronic and more difficult to manage. It can provoke ongoing changes in the way your nervous system and brain work. This can also affect several other body systems that the brain controls.

Many people will describe their pain increasing when they are at work or when they are in a stressful situation. Pain can be sent from your brain due to an environment that it suspects is unsafe- a threat. This is our brains way of protecting us.

Because we’re so used to pain working as intended, sufferers of persistent pain sometimes don’t understand why their pain remains. This often sees them search the merry-go-round of different opinions, looking for a quick fix with unrealistic treatment expectations.

So what to do?

Recognise that the mental and the physical aren’t separate. They interact and can influence each other. Intuitively we know it. When we are anxious we can feel our heart beating or hands shaking. Our mental anxiety is manifesting in an altered physical response. The same can happen with pain.

Get help. See somebody who takes the time to listen to your story in full, and helps you plan a path to recovery that takes into account your individual situation. Knowledge is power. For example a study has shown that education about pain can be more effective than core stabilisation in the prevention of low back pain.

But an important message we also need to convey is that chronic pain is not simply “in your head”. Chronic pain is very real and can be very difficult to understand as it is not always able to be “visualized” like a wound or a broken bone.

So, if you’re suffering pain that won’t go away, or an injury that hasn’t recovered, be proactive. Keep moving and understand that recovery is not “Just about the pain”.

Speak with one of our Physios to help you manage, understand and reduce the impact of persistent pain.