Experiencing pain beyond three months? Understanding why we feel pain and how it’s not always linked to tissue damage!

Article Written by Lani Watt Elite Senior Myotherapist

There are many kinds of pain. There’s the kind you experience from a fall, a spider bite or a muscle strain. These kinds of ‘everyday pains’ are easily understood as acute changes in tissue. The brain concludes that the body tissues are under threat and a response needs to be made to stop further injury and start a healing behaviour.  Pain however, can be a much more complex experience. Why does a back injury continue to hurt 30 years after the onset? We know most tissue damage heals within a few months, so what is happening to perpetuate the pain all these years after? To answer this we need a little lesson in pain neuroscience.

As we’ve evolved our bodies have designed a remarkable alarm system to keep us from danger and injury.  All over our body we have millions of sensors that can detect information from the tissues and relay it to the brain. We have sensors that pick up information on mechanical changes (such as stretch, pressure), temperature changes (hot or cold) and chemical changes (ie. lactic acid, allergens etc.). The sensors pickup this information and it’s is all sent to the brain by way of neurones. The brain then deciphers the information and decides an appropriate response.  If the brain perceives a threat, then it will respond with ‘danger’ messages and an illicit pain response to help avoid damage or injury. If however, the brain deems the information harmless, it will have no response and it will be ignored. Overall, this is a wonderful system to keep the body safe and from harm.

Unfortunately, like all systems there are some pitfalls. In many cases, where pain has been experienced beyond what would be deemed a normal healing time, we can have what’s called a ‘sensitised nervous system’. Essentially, our alarm system is on overdrive and working too well to protect our bodies from harm. What would have been deemed by the brain as harmless stimuli prior to the initial injury is now being perceived as a threat. In a previous back injury for example, something as simple as bending forward could be enough to set the mechanical sensors that pickup stretch off. The brain, in its attempt to protect the body elicits a pain message and all of a sudden the back is in spasm. As you can see from this example, the ‘well meaning’ alarm system is actually causing pain when there is no tissue damage present.

Common symptoms of a sensitised nervous system are:

·         Pain lasting longer than 3 months

·         The pain persists long after appropriate tissue healing times

·         The pain is spreading; when the alarm system is in a state of sensitisation, the brain is wrongly told by sensors that more and more of the body is in danger. The brain then sends pain messages to more and more locations of the body

·         The pain is worsening; as your alarm system is in overdrive it continues to increase the frequency of danger messages to the brain. The brain therefore concludes that the danger level has actually increased

·         Lots of movements hurt: As the sensitivity of the alarm system increases, less movement will be tolerated before the danger messages are sent

·         Pain can be unpredictable; it may hurt one day and not the next. An activity may cause pain one day and not the next etc.

If this sounds familiar it is likely that the process underpinning the pain you experience is not predominantly in the tissues, but in the nervous system in very real way. Many people with chronic pain have been on quite a journey, seeing multiple practitioners for help, getting scans that may provide little insight into the terrible pain they are experiencing. It can feel hopeless! The less that is found, the more worry we have that something must be terribly wrong.

If you’re in pain right now you aren’t alone. In fact it’s predicted that at any time on the face of the earth, around 20% of people have pain that has persisted beyond 3 months. Luckily, if you are reading this you are already taking the first steps toward helping yourself. Your Myotherapist can create an individual plan to help you out of the pain cycle including;

·         Education on why you’re experiencing pain

·         A plan to get you moving and doing the things you love through paced and graded exposure

·         A self-help toolkit for when you have a flare up or increased pain

·         Empowerment to understand why your body is doing what it’s doing and the strategies to help yourself

·         Strategies to reduce stress, as stress is a key contributor to persistent pain

Experiencing pain beyond three months? Understanding why we feel pain and how it’s not always linked to tissue damage!

There are many kinds of pain. There’s the kind you experience from a fall, a spider bite or a muscle strain. These kinds of ‘everyday pains’ are easily understood as acute changes in tissue. The brain concludes that the body tissues are under threat and a response needs to be made to stop further injury and start a healing behaviour.  Pain however, can be a much more complex experience. Why does a back injury continue to hurt 30 years after the onset? We know most tissue damage heals within a few months, so what is happening to perpetuate the pain all these years after? To answer this we need a little lesson in pain neuroscience.

As we’ve evolved our bodies have designed a remarkable alarm system to keep us from danger and injury.  All over our body we have millions of sensors that can detect information from the tissues and relay it to the brain. We have sensors that pick up information on mechanical changes (such as stretch, pressure), temperature changes (hot or cold) and chemical changes (ie. lactic acid, allergens etc.). The sensors pickup this information and it’s is all sent to the brain by way of neurones. The brain then deciphers the information and decides an appropriate response.  If the brain perceives a threat, then it will respond with ‘danger’ messages and an illicit pain response to help avoid damage or injury. If however, the brain deems the information harmless, it will have no response and it will be ignored. Overall, this is a wonderful system to keep the body safe and from harm.

Unfortunately, like all systems there are some pitfalls. In many cases, where pain has been experienced beyond what would be deemed a normal healing time, we can have what’s called a ‘sensitised nervous system’. Essentially, our alarm system is on overdrive and working too well to protect our bodies from harm. What would have been deemed by the brain as harmless stimuli prior to the initial injury is now being perceived as a threat. In a previous back injury for example, something as simple as bending forward could be enough to set the mechanical sensors that pickup stretch off. The brain, in its attempt to protect the body elicits a pain message and all of a sudden the back is in spasm. As you can see from this example, the ‘well meaning’ alarm system is actually causing pain when there is no tissue damage present.

Common symptoms of a sensitised nervous system are:

·         Pain lasting longer than 3 months

·         The pain persists long after appropriate tissue healing times

·         The pain is spreading; when the alarm system is in a state of sensitisation, the brain is wrongly told by sensors that more and more of the body is in danger. The brain then sends pain messages to more and more locations of the body

·         The pain is worsening; as your alarm system is in overdrive it continues to increase the frequency of danger messages to the brain. The brain therefore concludes that the danger level has actually increased

·         Lots of movements hurt: As the sensitivity of the alarm system increases, less movement will be tolerated before the danger messages are sent

·         Pain can be unpredictable; it may hurt one day and not the next. An activity may cause pain one day and not the next etc.

If this sounds familiar it is likely that the process underpinning the pain you experience is not predominantly in the tissues, but in the nervous system in very real way. Many people with chronic pain have been on quite a journey, seeing multiple practitioners for help, getting scans that may provide little insight into the terrible pain they are experiencing. It can feel hopeless! The less that is found, the more worry we have that something must be terribly wrong.

If you’re in pain right now you aren’t alone. In fact it’s predicted that at any time on the face of the earth, around 20% of people have pain that has persisted beyond 3 months. Luckily, if you are reading this you are already taking the first steps toward helping yourself. Your Myotherapist can create an individual plan to help you out of the pain cycle including;

·         Education on why you’re experiencing pain

·         A plan to get you moving and doing the things you love through paced and graded exposure

·         A self-help toolkit for when you have a flare up or increased pain

·         Empowerment to understand why your body is doing what it’s doing and the strategies to help yourself

·         Strategies to reduce stress, as stress is a key contributor to persistent pain