Explaining pain: Understanding the true nature of your pain

Pain science has come a long way in the last 15 years. We no longer rely on a purely biomechanical model (i.e. a degenerated joint = pain) to explain pain and have realised through extensive research in the field of neuroscience that pain is far more complicated than we ever thought before. This article aims to help explain some of the foundations of pain and what you can do to become more empowered to deal with pain.

Understanding pain:

1) Understand that pain is produced by the brain.

Many people in the healthcare profession are still struggling to understand the undisputed concept that that pain perception is produced by brain activity. Unfortunately, the cultural beliefs surrounding pain still tend to focus on pain as a reliable source of information about what is happening in the body. This is a false assumption and the leading cause of ongoing pain for most people. One of the most important phrases to remember comes from Dr. Karel Lewit who always states, “He who treats the site of pain is lost!”

2) Pain can be produced when the brain perceives that danger to body tissues exists and something needs to be done to avoid this. Pain should then be seen as a stimulus to create change.

The main goal of pain is to primarily provide a danger signal which should prompt action.

3) Pain is a part of the survival system, our brain and central nervous system can interpret any potential threat as pain.

Almost any stimulus can create pain if the brain interprets it as potentially threatening to the body. This shows us how multi-faceted the pain experience is. The brain can produce a pain signal in response to any stimulus or event that threatens your survival. Whether that event is emotional, physical, or even spiritual, if your brain perceives a threat to your ongoing survival there is a possibility that you will experience pain.

4) Pain is individual and each person must be treated as such

Life experience shows us that different people respond very differently to the same stimuli, whether that’s a stressful situation or a pain experience. In other words, two individuals struck with the same amount of force in the same place will often have two very different internal experiences of that event. Modern pain research points out the fact that there are many different factors that determine what types of and when stimuli are painful for each individual. Some of these factors are:

• Context – In what situations does someone experience the pain? If the pain is always present when moving while seated, changing the context and performing the movement while standing and talking with a friend may alter the pain.

• Posture – If the pain always accompanies standing movement, the same movement could possibly be performed pain-free while seated or lying.

• Competing Stimuli – Performing movements utilizing different visual or vestibular positions may alter the pain experience.

• Emotional State – A person may experience less pain whilst happy or listening to their favourite music versus when he is angry.

• Visualization – Imagining that the movement is pain-free prior to performing it can alter the pain event.

These concepts help us understand that pain is an event that is based on a person’s perception of that event. As a result, altering this perception of the pain event can have long-term consequences in either improving or worsening the pain experience.

So, what can we do? What strategies can we use to help deal with pain?

1) Make Pain-Free Training a requirement

This is a simple, but crucial concept. In a sense, if a person is moving and going through actions that are painful, they are essentially practicing being in pain, and as a result, this improves a person’s ability to be in pain! It is important to be taught how to move with pain-free precision to maximise the longevity of their body.

2) Reduce the Threat Level

Pain or poor movement and performance are danger/action signals in the body that result when the brain feels threatened. The primary goal in working should be to decrease the amount of threatening input/stimuli that their brain perceives. There are two primary means to accomplish this

A. Alter the Signals

This means to change the type of information coming from the affected area of the body, whether it’s the lower back, knee or shoulder. As well as looking at the joint level, it can also be important to assess and improve the signals reaching the brain from both the visual and vestibular (balance and spatial awareness) systems. Both of these systems are extremely vital to the body’s survival systems, and as a result, have a tremendous impact on pain perception. Just as in the proprioceptive (receptors in joints and muscles) system, disturbed signals from either the visual or vestibular system can result in painful symptoms.

• Move joints in a more positive, varied and controlled way
• Have the joints treated by an osteopath, chiropractor or physio.
• Try to optimise certain natural mechanics such as walking
• Change postural positions
• Alter visual inputs; i.e. eye exercises
• Visualise pain free movements and develop aspects of movement such as balance

B. Alter the Interpretation

This means to alter a person’s perception of their pain through becoming more educated about the situations that prompt the pain. Each person’s perception of their situation determines their pain levels. For many people the fear of injury, re-injury or long-term disability sensitizes their brain to increase their perception of pain. It is crucial that this is dealt with.

It is important to remember that pain does not necessarily indicate injury. As for such a long time, pain has been explained from a ’structural model’ i.e. if you have a damaged disc, this must be the cause of your lower back pain (we know this isn’t always true). This means that if a person always has their pain explained through a structural explanation, this builds unhealthy beliefs about their pain.

So if you are someone who has been dealing with ongoing, chronic pain or has a recurring sports injury or postural related pain, come and see one of us at DISC!

Kris R.