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Pain is our body’s alarm system. It warns us about potential danger or threats and motivates us to take action to protect ourselves. This is a good thing! Pain is necessary for survival. This type of pain is called acute pain and is usually a response to a potential tissue-damaging experience. Most of the time acute pain is easy to treat and slowly goes away over time.
But what happens when acute pain doesn’t go away? The term chronic pain is used to describe pain that lasts for longer than three months, long after an injury should have healed. This pain is no longer an accurate indicator of potential damage to the body. To make things worse, it’s sometimes not even possible to determine what the exact cause of the pain was in the first place. For many people this is a frightening and stressful experience, because we are used to pain going away after an injury has healed.
Chronic pain occurs because of changes in our nervous system. The nervous system is composed of our brain, spinal cord and nerves. Chronic pain occurs when changes in the nervous system cause our nerves to become overly sensitive and signal pain continuously. The pain alarm system is no longer helpful because the body is no longer in potential danger; in other words, the alarm is stuck in the “on” position.
The good news is that our nervous system is changing all the time – right now as you are reading this article your brain and nervous system are responding to information gathered from your environment. This is called neuroplasticity – the ability of the nervous system to change and adapt. An example of neuroplasticity outside of the realm of pain is when visually impaired people learn to read Braille. Over time, their fingers become much more sensitive and able to discriminate raised dots on a piece of paper.
In chronic pain experiences our nervous system becomes more sensitive to input. The pain alarm is much more sensitive. But we can use the idea of neuroplasticity to learn to turn down the alarm. Research shows that chronic pain benefits from a multi-faceted approach including the use of medications (where appropriate), cognitive therapy and physical therapy. Cognitive therapy is based on the idea that our thoughts and emotions can affect our pain experience. Physical therapy helps chronic pain by determining the level at which we can move and function without evoking the pain response. Lastly, a physical therapist can help create an individualized exercise or activity plan to re-teach the brain that movement is safe and no longer dangerous.
The fact is that chronic pain is very real. It’s a real experience created by our brain. Nevertheless we can re-train our nervous system to be less sensitive. This video provides a helpful summary of what chronic pain is as well as strategies that can be used to manage it.
As physiotherapists we can be very helpful in your recovery from chronic pain. Research shows that understanding how chronic pain actually occurs can be a helpful strategy for reducing the pain experience. If you are curious about this topic, be sure to ask one of us for a more detailed explanation and how the idea of an overly sensitive nervous system might be impacting your pain. We can guide you in the development of a personalized physical activity plan to recover your ability to function without evoking the pain response. Plus we can work together to develop individual strategies for managing painful flare-ups.