On the surface, pain might seem pretty straightforward: you jam your finger in a door—for example—and as a result, you feel pain in your finger almost immediately. But when you look at the process that leads to this painful sensation in more detail, you’ll see that what’s going on invovles several steps and is far more complicated than you probably think. Understanding how and why pain occurs may not seem all that important, but if you’ve ever experienced persistent—or chronic—pain, it’s actually the first crucial step needed to alleviate it. This is why our New York City physical therapists would like to explain how chronic pain works and why so many people struggle with it.
Acute pain is what likely comes to mind when most people think of pain. If you sprain your ankle while running or tweak your shoulder after throwing a football, the pain you experience immediately afterwards is called acute pain. But if this pain lasts for longer than three months—by which point most injuries have healed—it’s referred to as chronic pain. According to the CDC, about one in five people are affected by chronic pain, and almost half of these individuals report that the pain limits their daily activities. Some people deal with chronic pain for years without noticing any improvements, which may be due in part to outdated beliefs on the nature of their pain.
Recent developments in research have changed the way that we now understand pain. While it was once thought that pain could only be related to actual damage within the body, it’s been shown that pain is not an accurate predictor of tissue health. What this means is that you can experience the sensation of pain when there are minimal or no physical problems, or on the flip side, you can injure your body but not experience the sensation of pain.
Pain being ‘too’ protective
Pain is essentially the body’s protector. It protects you by creating unpleasant feelings that in turn cause your brain to change your behavior so you can avoid future injuries and allow the body to heal (think of pulling back your hand after touching a hot stove and then learning to avoid touching it again in the future). But the pain is not really “in” your hand (or wherever else you “feel” it.) Pain is actually a warning signal sent out by the brain that depends on credible evidence to tell you that your body needs protection and should therefore make a change of some sort. When it does its job properly, you will only “feel” pain when there is a threat or danger to your body that needs to be avoided.
But the problem is that sometimes pain can be too protective by sending out these warning signals unnecessarily, and this is at the heart of understanding chronic pain. The body can produce these unnecessary warning signals in a number of ways, such as conditioning, in which the body essentially “learns” pain after experiencing repeatedly.
The body contains specific neurons called nociceptors that normally only respond to painful stimuli, like heat or pressure. When activated, they send a warning signal to your spinal cord, which can then in turn send this signal to your brain. The brain then interprets the information it receives and the information already stored based on prior experiences with pain. From here, the brain determines if it’s necessary to protect the body, and if so, tells you that you’re in pain. But the brain can make mistakes, which may cause you to experience pain based only on thoughts or memories, when there is no physical stimuli or tissue damage present.
The body can “learn” pain when it wrongly creates a painful sensation over and over. The longer your nervous system produces pain, the better it gets at producing it, which is what happens in individuals with chronic pain. Long after an injury has occurred, even though there is no longer any physical damage or inherent threat, the body has gotten so accustomed to creating pain that even slight triggers can set it off. This is why emotions are so tightly associated with chronic pain, as experiencing a stressful event can be misinterpreting as a threat to the body and result in a painful sensation in areas affected by chronic pain.
We can help you understand the source of your chronic pain and retrain your brain
Therefore, coping with and overcoming chronic pain starts with figuring out why it’s there in the first place and how it gets triggered. If you can understand these factors, you can learn to identify chronic pain and stop it in its tracks. Over time, you can come to retrain your brain so that it no longer creates pain mistakenly and eliminate your chronic pain in the process.
Our New York City physical therapists can help you get to the bottom of your chronic pain and then provide a set of strategies to help you understand and overcome it. Contact Dynamic Sports Physical Therapy at 212-317-8303 to schedule an appointment today, or click here for more information on chronic pain.