Understanding Pain – Part 1 - Pain 2 Possibilities

Understanding Pain – Part 1

Yes, chronic pain is a wildly complicated, complex process.

At Pain 2 Possibilities, we believe that managing your pain means truly understanding your pain.

So just like any good story we are going to take you back to the very beginning…

When you were born, you were equipped with some pretty amazing ‘built ins’. You acquired a body and a brain that combined is a machine that is intuitive, adaptable and responsive. It may not always feel like an amazing machine when you are living day in and day out with persistent pain. But I am here to remind  you just how amazing you and your systems really are! Each and every day your body and brain are going through some pretty complex processes to sustain you. Let’s take a moment to showcase some of those innate features.

When your body temperature rises due to environmental, exercise, hormonal factors and illness, your body instinctively knows what to do to protect your cells. Once your core reaches a certain temperature your body begins to sweat to start the cooling process.

When there is a stimuli (also known as a threat),  perceived or real,  the sympathetic nervous system stimulates the adrenal glands to trigger the release of neurotransmitters (adrenaline). This results in an increase in heart rate, blood pressure, and breathing rate to help get you into fight or flight mode (or sometimes the ‘deer in the headlights’ freeze). This all happens at lightening speed to prepare you for what ever decision you make…to defend, to protect.

Or how about the high speed withdrawal reflex when your hand senses extreme heat on a stove top of which includes a sensory input, central processing, and motor output. This all happens without us even having to think of it nor control it consciously. That’s a highly sophisticated process that happens in a very short period of time and it is meant to protect us from harm. Your limbic system is pretty incredible.

For our last example, I want you to take a moment and think about your favourite meal. Think about what it looks like, what it smells like and finally what it tastes like. Take your time and think of that meal in detail. Now notice what your mouth and salivary glands are doing.  This stimuli and response is incredibly powerful! And it is one of the best examples we have of how your thoughts affect or influence your physical self (which we will address in another post).

Why is this important? Because pain has purpose. Pain is our bodies natural defence mechanism against harm when exposed to a short term stimuli like an injury, damaged tissue, bruises, for real and perceived danger.

Acute Vs Chronic Pain

So our next step in understanding pain is deciphering between Acute and Chronic Pain and how one becomes the other.

Acute pain, as described by webmd.com ‘comes on suddenly and has a limited duration. It's frequently caused by damage to tissue such as bone, muscle, or organs, and it usually disappears when the underlying cause of pain has been treated or has healed.’
Whereas acute pain lasts for days up to 6 months, chronic pain lasts for much longer and is much more complex. It is the pain that stretches beyond the tissue healing.

So how does acute pain become chronic? There is still much to learn about this transition but what we do know is described best by ‘Medpage Today’. They state, ‘acute pain progresses to chronic pain when repeated or continuous nerve stimulation precipitates a series of altered pain pathways, resulting in central sensitization and impaired central nervous system mechanisms.’

Let’s unpack this a little bit. The key concepts in this description are ‘repeated or continuous nerve stimulation’, ‘altered pain pathways’ and ‘impaired central nervous system’.

Nerve stimulation can come from many different sources and can be both physical and emotional in nature. In the world of pain education we call it the Biopsychosocial model, where pain is an intertwining of biological, psychological and sociological factors (stay tuned for more on this). When our nervous system is constantly bombarded with stimulation of pain, worry, fear, stress, trauma, self doubt, and more our pain pathways become physically changed thereby impairing their function. This includes impaired sleep, immune function and overall healing. Just like our Wifi…our nervous system can become ‘glitchy’ (I hear this word A LOT when my son is complaining about our Wifi).

So what is the good news? Just because those pain pathways in your nervous system have been altered does not mean that they cannot heal. They may never be ‘fixed’ but they can be improved which inevitably will change your experience with pain. Neuroplasticity, as defined by Oxford Languages is the ‘the ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury.’ Yes, you read that correctly, your brain can regenerate and change, it just takes some know-how and lots of practice.

Stay tuned for our next instalment where we will discuss the Biopsychosocial model (it is such an important part of your pain experience that it deserves it’s own blog post!)

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