What is Pain?

Pain is an internal system that alerts us to danger in the body, for example, stepping on a sharp nail or touching a hot stove. Pain is a universal human experience and is 100 per cent produced by the brain. Pain involves two components.

1. Sensory nerve signals from the body to the brain

2. A complex analysis and interpretation of these signals by the brain

Classification of pain

Acute pain: Pain of less than three months duration common with associated tissue damage, for example, back injury or a sprained ankle. After an acute injury, the body wants to protect the problem area to help it heal. The body releases chemicals to make the nerves more sensitive which make it easier to trigger pain to warn us to be extra careful with that body part as the tissues heal. Protective nerve “hyper-sensitivity” sticks around for a few weeks then it is supposed to settle down and disappear.

Chronic Pain: Pain lasting for more than three months, or persisting beyond the course of acute injury and after tissue healing is complete. Tissue damage is no longer the main issue. The pain system can malfunction like any other system in the body. In this case, the brain produces an excessive amount of pain signals and the hyper-sensitivity persists longer than it should. Excessive pain is caused when the body’s nerves become too sensitive and turn on too easily. The nerve hyper-sensitivity may even spread to other parts of the body and cause pain in areas away from the original site of injury.

What can you do about it?

Having a brain that keeps producing pain, even after the body has repaired itself and is out of danger is no fun at all. It can be very frustrating especially if you cannot do the things that you normally do to enjoy a quality of life. Some people say it feels like they must still have something wrong. But once everything dangerous has been ruled out, health professionals can explain that most things in the body have healed as well as they can be, by three to six months. Therefore, ongoing pain is less about the structures in the body and more about the sensitivity of the nervous system.

The most effective strategy is to help the nerves of the pain system become less sensitive by “retraining” the brain and nervous system. This is best looked at from a broader perspective and an active, multi-factorial approach as follows:

1. Medical approach: Health professionals such as GPs and physiotherapists can assist in the management of chronic pain. Your GP may prescribe medication to help in the short-term. It is important to realise that long-term use of medication can be dangerous/toxic within the body. Too many people take medication out of routine for fear that their pain may get worse when in fact it hasn’t gotten significantly better. Your physiotherapist can guide you through an appropriate treatment (massage, acupuncture/dry-needling etc) alongside a specific exercise programme (clinical pilates or yoga, for example)

2. Thoughts and emotions: Pain impacts on people’s lives and can affect mood and stress levels. Learning ways to reduce stress to wind down the nervous system can help emotional well-being and can reduce pain.

3. Diet and lifestyle: Consider your current lifestyle e.g. smoking, alcohol, sleep patterns and activity levels etc. What changes can be made to improve this?

4. Psychological well-being: Taking a look at the deeper meaning of your pain and surrounding personal story. What happened around the time the pain developed? There may be a link between a distressing period of your life and a worsening pain picture. Speaking to someone about this can be a part of the healing process.

5. Physical activity and function: Getting moving at a comfortable level without fear and where the brain does not feel it needs to protect itself by pain can gradually restore normal tissue function. Set some achievable goals and work towards them.