Neuroscience Behind Chronic Pain
Pain is normal. Living in pain is not. Are you amongst the 20% of the adult population living with chronic pain? Seven percent of adults report chronic pain to be limiting life or work-related activities. The better question is, what can you do about it?
Persistent pain is more due to the sensitive nervous system and how the brain processes information from the body and environment. Our bodies contain more than 45 miles of nerves that connect like a network of roads to the spinal cord. The spinal cord connects to the brain where the information from our tissues is analyzed.
Think of our roadmap of nerves as an alarm system, consistently monitoring our body. Our nerves are resting at a “normal excited level”, patiently waiting for a stimulus to tell the brain about. If you were to step on a nail or touch a hot plate, these nerves sense danger and relay the message to the brain to cause you to limp or draw back your arm quickly. After the incident, it would be normal for the nerves to return back to the “normal excited level.” However, this is not always the case. Sometimes these nerves, or alarms, can remain “excited” or extra sensitive.
If our nerves do not return to their normal excited state, they can remain extra sensitive and contribute to chronic pain. You may fit the category for a heightened alarm system if: your tolerance to activity level before reaching pain has decreased, pressure on your skin is sensitive, it hurts to just move your body parts, and your doctor has prescribed medication to calm nerves.
Think of it as sensitivity rather than injury.
When you have a heightened alarm system in one area of the body, it is possible that other neighboring areas of the body may become irritable as well. Old injuries, surgeries, scars, etc. may become more sensitive. It is important to understand this is not a new injury but a sensitivity due to the heightened irritability of the nervous system.
Contributors to pain:
Pain is a decision by the brain. Tissue injury is not needed for pain; stress alone can cause pain. These stressors will allow the brain to perceive it as a threat. Due to the sustained heightened response of stress, the body may cope with the following: tender areas in muscles and nerves, mood swings, appetite changes, fatigue, weight gain, sleep disturbance, stomach sensitivity, depression, poor concentration or focus, and postural changes. Understanding the foundation of how your brain perceives pain is the first step to treating pain.
How does this help me? What can I do about it?
Studies have shown that nerves will immediately start calming down when there is awareness regarding the root of the pain. Therefore, understanding the heightened alarm system concept and stress contributors can make you more aware of your limitations and ways to cope. Research has shown that an increase in heart rate and blood flow from aerobic exercise helps get oxygen to the body and calm the nerves. This can include 10-20 minutes of brisk walking, biking, swimming, and low-impact aerobics. It is important to log your progress and set goals. It is okay to start with five minutes of exercise, progressing 1 minute each day until reaching 20 minutes of total exercise. It is important to remind yourself that if you experience pain while exercising, your receptors are sensitive and you are working to make them healthier. Therefore, your workouts may not start out pain-free. Sleep is also important for healing and stress reduction; recommended eight hours. An anti-inflammatory diet can also reduce internal stressors.
The main goal of treating persistent pain is to gain knowledge of your pain. Empower yourself, choose to be healthier in diet and exercise, sleep well, and understand the road to recovery is a marathon and not a sprint. Establish goals, log your progress, and hold yourself accountable. The first step in treating chronic pain is understanding the neuroscience of pain. The decision is ultimately yours.
If you are someone living with chronic pain and would like to communicate with a physical therapist, email us at info@imovephysicaltherapy.com. For more information on chronic pain, tune into podcast #11 “Understanding Chronic Pain” on the Healthy Habits for Active Aging podcast hosted by Dr. Lauren Bennett, PT, DPT, OCS and Dr. Michael Gorman, PhD, PT, DMT, FAAOMPT, on Spotify, Google or Apple Podcasts, or the iMovePT youtube page.
By: Dr. Lauren Bennett, PT, DPT, OCS