Understanding Pain

How does our pain system work?

When you hurt yourself special nerves called nociceptor (from Latin nocere - “to harm/hurt”) send electrical signals to your brain. When the brain receives this message of “tissue damage” it then chooses to trigger the pain alarm signal as a response to protect your body. Based on your level of perceived threat to the body the brain can choose the volume of the pain alarm signal.

If nociceptors (nerves that detect damage) are activated repeatedly the brain may decide to be more sensitive to adequately protect the body from threats. More stress sensors can be added to nerve fibres until they become so sensitive that even light touches to the skin can send signals to the brain indicating damage. In other words, nerves adapt to become more efficient at sending signals of damage, amplifying the message. 

  

These forms of amplification are most common in people with chronic pain, which is defined as pain lasting greater than 3 months. When the nervous system is forced into a system of high alert sometimes pain can outlast the tissue damage.

What influences my pain? 

There are other factors besides “nociception” that can influence the experience of pain, and make pain less useful.

Psychological factors play a big role. There is a growing field of evidence that has shown our emotional state, beliefs about pain, memories and expectation from treatment can all influence how much pain we experience. 

If you’ve hurt your back bending forwards and had two weeks of excruciating pain, you may become fearful and tentative around the stability of your back while bending forwards. Which means next time you tweak your back bending forwards, your previous experience of pain and associated fears affect your current perceived level of threat to the body; resulting in high levels of pain. This amount of pain may not reflect the actual “tissue damage” to your back.  

Does this mean that my pain is in my head? 

No! Pain is a real experience, that’s subjective to people. The point of this blog is to reassure you that it is not always linked to how much damage there is. We’ve come to find that pain correlates very poorly with tissue damage we see in MRI’s all over the body. It’s important to understand that pain can be greater than the damage to the body due to sensitisation, and psychological factors.

So what does this mean?

Pain can cause unhelpful and protective responses in your body after the tissue healing process has completed (> 12 weeks). This requires a different mindset in terms of treatment. The goal of treatment is not to “let the body heal properly”, it is to reduce the “sensitivity” of the tissues by gradually exposing the body to more load over time. This can be done through various ways including, massage, manual therapy, chiropractics, exercises, however the first step is knowing what your pain means, and reassuring yourself that you’re not doing more harm. 

If you’re in a constant state or a cycle of pain, we can help you move on with life and prevent pain in the future. If you have any questions, give us a call on 3399 3318.

*Always consult your doctor for pain that is severe and/or unfamiliar.

 

Pranay Singh

Physiotherapist

PEAK

 

References

Greg Lehman, G., 2021. Pain Science Workbooks — Greg Lehman. [online] Reconciling Biomechanics with Pain science. Available at: <http://www.greglehman.ca/pain-science-workbooks> [Accessed 9 September 2021].

Youtube-TED-Ed. 2021. The mysterious science of pain - Joshua W. Pate. [online] Available at: <https://www.youtube.com/watch?v=eakyDiXX6Uc> [Accessed 9 September 2021].

Sandip Sekhon, S., 2021. Pain Science Gems from Prof. Lorimer Moseley. [online] Pathways. Available at: <https://www.pathways.health/pain-science-gems-from-prof-lorimer-moseley/> [Accessed 9 September 2021].