Understanding, Managing, and Preventing Chronic Pain: Part 2
Updated: Aug 24, 2022
Your Brain is your Body’s Alarm System
As we discussed previously in Part 1 of our Pain Blog Series, pain is protective.
It allows us to safeguard ourselves against something that is potentially threatening to our health.
Let’s compare our brain to an alarm system in our home – they have similar roles.
If there’s a break-in to our home, we want our alarm system to alert us so that we can alert the police and protect the home and our valuables within it.
Much like if we have a cut on our hand or sprain an ankle, we want our brain to alert our consciousness of these potential threats to our well-being so that we can address them appropriately.
Clean the cut, put on Neosporin, bandage it so that we can facilitate the healing process and prevent infection. Or limit how much weight going through the sprained ankle, elevate, wear a compression garment – again to facilitate the healing process.
Now imagine for a moment that our alarm system could learn and grow (they probably will soon with Artificial Intelligence developing at the rate it is haha).
Here’s what I mean… Imagine your home is broken into. Burglars destroy the lock on your front door and damage multiple valuables inside. Then it happens again a month later. Then again, a few months after that.
Well, if your alarm system could learn and adapt, it would be on ultra-high alert and would want to make sure it prevents another break. It would attempt to be more proactive than reactive because it would be tired of the house getting damaged and belonging getting stolen. Now that it is at this higher level of awareness and feels the need to protect, even Amazon knocking on your front door causes your alarm to sound to prevent another break in from occurring.
Now consider this…our brains actually DO learn, grow, and adapt...
Let's say you have one bout of back pain from squatting at the gym that takes you away from work for two weeks. Then you have pain on vacation when picking up your young child that effectively ruins your vacation. Then you hurt your back again a few weeks later bending down to tee your ball on the 9th hole and your pain doesn’t allow you to finish the back nine.
Well now your brain, your body’s alarm system, is hyperalert and sensitized to the smallest change. And now it hurts just to bend over and brush your teeth in the morning because your brain is trying to prevent another injury. Bending over to simply brush your teeth likely does not put enough stress through your lower spine to cause actual damage, but your brain is fearful and apprehensive about another injury like the ones you've suffered in the past that have kept you away from enjoyable activities and hobbies or away from work which is necessary to make money and survive.
This is conceptually how chronic pain occurs. Our nervous system, which is responsible for relaying information from our muscles, tendon, joints ligaments to our brain and back to our skeletal system is now overly sensitive and is trying to protect you from further injury. And as we’ve discussed in the first part of this blog series, pain does not equate to tissue damage. When you simply bend over to brush your teeth in the morning there isn’t necessarily an injury occurring, however, you feel and perceive pain in your lower back. Its only Amazon knocking on the door, but your brain is fearful of another break in.
As I said pain is multifactorial. This fear and apprehension that is built over time is simply another one of the factors. This is not to say that physical, tissue damage isn’t involved at all. Even in chronic pain there are physical impairments that need to be addressed.
But this is how chronic pain develops. When you have a bad injury, there is obviously going to be tissue damage, inflammation and pain directly correlated with that injury that keeps you away from certain activities for a period of time. For instance, if you did have a moderate herniation of a disc in your low back, it takes about 6-8 weeks for that disc to heal. Just like if you have a cut on your arm it takes several days for the body to lay scar tissue and heal the skin. But the disc will heal… so why is it that you’ve had back pain for the last three years? Well, it's what we just discussed. Your body’s alarm system is overly sensitive and fearful of another injury occurring. So, it outputs the sensation of pain even though no injury has occurred again.
Fear Avoidance Behaviors
The above scenario is all too common. You have one minor injury, you heal from it, but your pain continues. And this leads to a lack of confidence to return to the activities you love because you know they have led to pain and disability for you in the past. You’re now avoiding going back to the gym and squatting heavy, you are avoiding playing with your kids, your avoiding going golfing. Essentially, you're afraid of hurting again. And that fear is normal to some extent. But this leads us to the good ole’ saying, “if you don’t use it, you lose it”.
Now, your nervous system is overly sensitized, and you have developed an apprehension to repeat the activities that led to your injury. And while you're avoiding returning to these activities, your body gets weaker and tighter in the areas that need to be strong and flexible to avoid these injuries again on a physical level. Without realizing it, you're leading yourself down the viscous cycle that is chronic pain.
So, my biggest piece of advice is to properly manage your pain in the acute stage soon after you first start experiencing pain. Call us when you have an injury. Don't wait weeks or months thinking it'll just go away because it probably won't!
Also, check out a recent blog post of ours on how to manage acute soft-tissue injuries. Click the button below!
But the other question is this...what if I already have chronic pain? How do I get out of chronic pain that has been around for months or years? How do I return to the activities I love without pain again? How do I get rid of the fear to be able to lead to a road of recovery?
Stay tuned for Part 3 of this series where we discuss the answer to all of these questions!