Have you been living with pain for months? Maybe even years? Experiencing pain is a normal part of life, but living with chronic pain is not normal. Chronic pain is exhausting. It can affect a person’s ability to work, to go to social gatherings, and participate in the activities they enjoy. Is there any hope of ever finding relief from chronic pain? There are several things to consider that contribute to pain and how the body responds to pain when seeking relief from chronic pain. Thankfully, there are therapy options for chronic pain sufferers.
Often, individuals with chronic pain receive several explanations for their pain. They may have also tried several types of treatment and several pain medications. These efforts have likely helped manage pain for a short time or have taken the edge off the pain. This leaves individuals wondering if there is hope of ever truly healing and reducing pain. Understanding why this pain persists can help individuals find the best treatment to help them heal from their constant pain.
If you cut your finger, would you want to know about it? Of course! How would you know? The nerves in your body would tell you. There are more than 400 individual nerves in the body. These nerves are connected and create pathways to send information. The nervous system sends an alert to the brain saying ‘danger: you cut yourself.’ Once the threat (injury) is over, the nerves calm back down and slowly the pain from hurting yourself begins to fade away. This is normal, and it is difficult to survive without this process.
When the nervous system ramps up due to pain, it should calm back down once the threat has been acknowledged and the body begins to work on addressing It. Approximately 25% of individuals have an alert system that does not calm back down as it should, thus creating an extra sensitive alert system.
Prior to the onset of chronic pain, the body’s alert system tolerated activity at a normal pace. With an extra sensitive alert system, activity causes the alert system to ramp up much faster and pain is produced at a much quicker rate, giving individuals less room for activity before pain sets in. The individual can now only tolerate a 10-minute walk, rather than a 2-mile run.
What causes an individual’s alert system to remain extra sensitive? What most individuals don’t realize is that pain involves multiple systems in the body. It is not a simple matter of one system resetting and learning to function as normal. Instead, several systems must work together to regain homeostasis.
Did you know there is no place in the brain specifically designed just to house pain? In fact, there are eight different areas of the brain that light up with pain. The central nervous system is responsible for sending the pain alert to the brain, but once this occurs, it wakes up the other systems and when it remains extra sensitive the other systems to become affected. Every region of the brain that is affected by pain has a different primary function. During pain, the brain is having difficulty focusing on its primary job because it is sharing that same space with pain.
The eight important areas of the brain that light up when pain occurs:
- Premotor cortex–responsible for planning and executing body movement
- Cingulate cortex–responsible for focus and concentration
- Prefrontal cortex–responsible for memory and problem solving
- Amygdala–responsible for fear, addition, and emotion
- Sensory cortex–responsible for sensory discrimination
- Hypothalamus–responsible for regulation of body temperature and stress
- Cerebellum–responsible for balance and proprioception
- Hippocampus–responsible for spatial recognition
If you deal with ongoing pain you may have noticed it’s hard to think clearly, but didn’t understand why. These eight areas of the brain are thinking about pain while still trying to maintain homeostasis for the body. Because pain affects many parts of the brain, individuals will need to address multiple systems to calm the alert system back down.
The brain changes during pain experiences as it takes in information and data. Fear of movement, anxiety, ongoing pain, failed treatment, multiple explanations for pain, job issues, family concerns, and emotional trauma are just a few of the factors the brain is considering when determining to ramp up or calm down the alert system. Your brain is also considering temperature, blood flow, adequate sleep, and stress levels. This is why individuals may notice their pain is worse when one or more of these factors are amplified.
The good news is, there is hope for chronic pain. There are several things you can do to help reset the alert system and calm down the overactive signal being sent to the brain.
Education is key; understanding what is occurring in the brain when an individual feels pain is vital to reducing the overactive alert system. Pain is not “all in your head”—It is very real and is generated by the brain. It takes time to retrain the brain to reduce the alert system signal.
Working with a physical therapist who you can trust, that understands the neuroscience of pain and is able to teach you how to set proper goals and expectations to calm the alert system down, can retrain the body to move within normal limits again. Chronic pain therapy plans must be individualized to help manage what activity should be added each day and what goals will be important for each person to succeed.
Adding a movement component is very important to the treatment plan. Physical therapists are movement specialists and are best qualified to teach people how to move within limits that will not exacerbate their symptoms and can teach how to get out of the cycle of overdoing activity one day and paying for it in the days to follow.
Manual therapy plays a significant role in resetting the alert system and can help increase blood flow, loosen stiff joints, decrease soft tissue limitations, and help realign joints. This too is carried out by the physical therapist you trust.
Sleep deprivation makes it very difficult to overcome chronic pain and reset the alert system. Pain makes it very tough to sleep and a lack of sleep increases pain. So what is the solution? Creating a concrete sleep schedule is helpful. Get up and go to bed at the same time each day and resist the urge to take a nap. When discomfort at night plays a role in losing sleep, a physical therapist will be able to assist with positional changes that may be more comfortable to ease the pain.
And finally, an individual’s beliefs play a substantial role in resetting the overactive alert system. It is important to understand the pain and how it affects the body. There is hope in living with less pain and a purposeful lifestyle. Often, individuals start to believe they have had pain so long and have suffered so long that they are now beyond help. Small changes can make a big difference in the day-to-day routine. Individuals should not stop moving because they have pain. Instead, they should learn to move within their limitations through the guidance of a physical therapist. Through this guidance, they can start to restore normal movement patterns.
In conclusion, pain is a vital function of the nervous system that provides the body with a warning of a potential or actual threat. It is affected by past experiences, beliefs about pain, fear, and anxiety. An overactive alert system is easily ramped up based on the brain’s response to these factors. However, there is hope in resetting the overactive alert system. Medical professionals who are trained in understanding the neuroscience of pain can help. Visit a physical therapist at a Foothills Sports Medicine location near you to start a chronic pain therapy plan.