Chronic Pain Management

Chronic or persistent pain is pain that lasts longer than the normal expected recovery time.  Unlike acute pain, the signal from the tissues is a much smaller (but still important) part of the pain experience.  Your tissues send signals along your nerves to the spinal cord which acts as a relay center to the brain.  Based on how much danger the brain perceives though, it can “turn up” or “turn down” how much information is allowed to pass through the spinal cord to the brain.  If something seems important, the brain will want a lot more information whereas if something is not important (i.e. the feeling of clothes on our body), the brain will not want as much information about it.  Thus, if there is more credible evidence of danger than safety the spinal cord will magnify how much signal is allowed to pass from the tissues to the brain.  The brain receives the out-of-proportion signals and makes appropriate decisions based on incorrect information.

One worry that patients who live with chronic pain have is that other people may think they are crazy or think “its all in your head”.  Notice though that your brain is making good decisions based on the information it receives…it just so happens that that information does not accurately reflect the reality of what is going on at the tissue level. This type of pain is maladaptive, meaning it is of no benefit to us.  The protective responses that our brain produces may tell us not to do things such as being physically active, returning to work, or doing normal household chores for fear that doing so will cause further harm.  In reality though, doing these things has been shown to result in better improvements in pain and function than does resting.

Understanding how pain works is important in order to feel better!  First of all, just having a better understanding of what’s going on with your body, knowing that it’s common, and that you’re not crazy helps calm some of the fear and anxiety over your pain which actually changes the pain itself!  Secondly by understanding that ongoing pain is not reflective of tissue damage, you can resume your normal activities and gradually increase your physical activity level with the peace of mind of knowing that you will not cause further damage.  Since physical activity level and being able to fill our roles in society (i.e. parenting, housekeeping, returning to work or sports) affect the amount of perceived threat, this also helps decrease pain.  Finally, knowing that pain is a multi-factorial problem, it allows you to choose treatments that address all aspects of the pain.  Physical factors such as posture, body mechanics, and muscle strength are still important, but they only address the “bio” part of the “biopsychosocial” experience of pain.  The chronic pain experts at More 4 Life  can teach you strategies to improve sleep, manage stress, increase activity level, and modify the way that you do certain activities in order to allow you to perform them with less pain.