Chronic Pain and The Nervous System: Causes, Symptoms & Treatment Options

Nov 18, 2021

Foothills Sports Medicine Physical Therapy

by Foothills Sports Medicine Physical Therapy

Experiencing pain may be part of life but living with chronic pain is far from normal. It can be exhausting, affecting your ability to live an active life, complete job duties, and get the rest you need. Ongoing pain can result in anxiety, insomnia, and depression. Going through physical therapy can often reduce or eliminate pain, letting you get back to your life.

What is chronic pain syndrome?

There are two primary categories of pain. Acute pain is often a symptom of an underlying health condition. Recovery may take days to weeks, and the pain subsides. In contrast, chronic pain, or chronic pain syndrome, typically lasts six months or longer. It occurs in addition to the pain caused by the health condition, which may or may not have healed. It’s independent of the original injury or illness that started it and may last long after that pain subsides.

Chronic pain can come in many forms, such as the following:

  • Back and neck pain
  • Joint or arthritis pain
  • Cancer pain near a tumor
  • Testicular pain
  • Headaches, including migraines
  • Pervasive muscle pain (including fibromyalgia)
  • Lasting pain in scar tissue
  • Neurogenic pain from damage to the nervous system

More than 20% of Americans have chronic pain that impacts job and lifestyle activities.

What causes chronic pain?

Sometimes chronic pain has an apparent cause, such as a long illness, cancer, or arthritis. Diseases can leave your body more susceptible to pain, even after you recover. Injuries, including broken bones, sprains, or infections, can also leave you in chronic pain.

Pain that appears to be unrelated to a physical illness or injury is psychogenic pain. It’s believed that anxiety, stress, and depression result in low endorphin levels in the blood. 

Regardless of the specific cause, pain is a function of the nervous system. Nerves around an injury site detect the damage and send signals to the spinal cord and up to the brain. The brain registers the pain, and the nervous system reacts. Muscles tense, emotions run high, and the nervous system shifts to a hypervigilant state.

When dealing with acute pain, this high alert status is beneficial. It tells the body that something is wrong allowing us to protect against further injury. Once the damage or illness heals, the nervous system goes back to functioning normally.

Symptoms of Chronic Pain Syndrome

When the nervous system remains in a persistent state of high alert, it often becomes hypersensitive. It can maintain the pain, even after the original damage heals. People with chronic pain describe it in a variety of ways:

  • Throbbing
  • Stiffness
  • Shooting
  • Aching
  • Burning
  • Squeezing
  • Stinging

Poor sleep, mood swings, irritability, and fatigue often accompany the pain, which adds to stress levels and increases the nervous system’s reactivity. If pain increases, another vicious cycle starts.

Patient with resistance band.

7 Common Treatment Methods for Chronic Pain

Chronic pain can limit your quality of life and lead to significant long-term health problems. It can make it challenging to manage daily tasks, maintain relationships and preserve financial stability. Chronic pain is uniquely personal, and finding an effective treatment becomes a priority. 

Your biology and personal history can affect which pain therapies provide relief. The treatment combination that works for one person may not work for another.

1. Physical Therapy

Physical therapy is a very personalized treatment regimen. Goals may include increased mobility and decreased pain levels to help you become fully functioning. PT includes passive and active treatments. Your program may begin with passive treatments and move into active methods. Physical therapists play a major role in pain management through different types of therapies and techniques used daily. Various forms of exercise including strength, flexibility, balance, endurance, power, and agility are used to promote and restore normal function, but also as pain management. Whereas opioids only mask the sensation of pain, physical therapists can also treat pain through hands-on care. Techniques used include manipulation, joint, and soft tissue mobilizations, dry needling, cupping, and others. This assists in not only addressing the pain but focusing on the root of the issue.

2. Contrast Therapy

Physical therapists often alternate between cold and hot therapies. Cold therapy constricts or narrows the blood vessels. Inflammation lowers when the muscles contract and pain signals are reduced. Heat therapy increases circulation by expanding the blood vessels. Flooding the area with nutrients and oxygen reduces muscle pain, and the body’s cells can shed waste products. Contrast therapy can reduce inflammation and stimulate circulation, which loosens tight, aching muscles.

3. Deep Tissue Massage

Muscle spasms and chronic muscle tension can build through the stress of a typical daily routine. Cramps can also occur due to sprains and strains. The direct pressure and friction applied during the massage can release the tension in the muscles, ligaments, and tendons.

4. TENS (transcutaneous electrical nerve stimulation)

A TENS machine uses variable intensities of electrical current to stimulate muscles, which helps reduce the occurrence and severity of muscle spasms. It may also increase the production of endorphins, which are the body’s natural pain killers. You may use only the machine located at your physical therapist’s office, or you may also have a smaller machine made for at-home use.

5. Ultrasound

This deep heating technique is applied to your skin. As the waves of heat seep into your tissues, it is believed to improve blood flow and circulation. An ultrasound helps reduce cramping, swellings, spasms, pain, and stiffness.

6. Drug Therapy

Over-the-counter medications may be enough to relieve mild pain caused by stiffness, inflammation, and muscle aches. Typical drug therapy includes ibuprofen, aspirin, naproxen, and acetaminophen (Tylenol). Topical pain relievers that come in sprays, creams, and lotions may also provide temporary relief. Stronger medications for debilitating pain range from prescription NSAIDs, muscle relaxants, and anti-anxiety drugs to opioids and steroid injections.

7. Exercise

Exercise is an active treatment and it’s an essential part of the PT toolbox for improving mobility and strength. As the pain eases, the brain stops sending constant alerts to the nervous system. You and the physical therapist work together when developing an exercise regimen that can provide pain relief. Examples of low impact exercises include the following:

  • Swimming
  • Stretching and strengthening exercises
  • Cycling
  • Walking
  • Tai Chi
  • Pilates
  • Yoga

Through exercising, you get stronger and train your nervous system to trust that movement is safe. This allows it to move from high alert to normal functions.  

If you have pain that comes and goes, physical therapy may help you understand the cause and how to treat it. Each person responds to physical therapy differently. Contact us today to schedule an appointment and learn more about the treatment options that work best for you.

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