For those of us who have experienced chronic pain or, have a loved one with chronic pain we often find confusing information in our search for relief and understanding. I hope this Question and Answer series on the ‘truth’ and ‘myths’ of chronic pain can help educate and assist people on their journey.
“Chronic pain is just really bad and severe pain”… MYTH – Chronic (or persistent) pain relates to pain that keeps going for longer than we expect it to (longer than 3 months).. Although it can definitely be severe!
“I am in still in a lot of pain 6 months after my injury, something still must be broken inside”… MYTH – persistent pain often does not indicate ongoing damage, and is less to do with the injury and more to do with our central nervous system – the volume knob on our pain system has been stuck on ‘loud’. We can guide you in turning the volume down, but in the end it is up to you to take charge.
“Another health professional has said I have degeneration/disc bulges/scoliosis/misalignment/a spine of an eighty year old – therefore I’ll always have pain right?” – MYTH – while imaging can be an important tool to rule out very dangerous pathologies (we call these ‘Red Flags’ – but these signs only occur in less than 5% of patients), many of these findings do not relate to your current pain. Recent research has shown that there is often a poor correlation with pain and imaging findings in low back pain. When reading the wording in these reports, it can actually make your pain worse because…
“Only the brain produces pain”… TRUTH – when you stub your toe on the corner of the coffee table (or in my case my daughter’s toy pram), the nerves in your toe just tells your brain that ‘something has happened, it may be dangerous’. It is your brain that interprets this and says “this hurts!!”. Before this, your brain has weighed up hundreds of life factors such as what you do for a job, your personal and cultural beliefs, past history of toe stubbing events, what your plans are in the future and lots more and does this so quick well before we are aware of anything. This all affects the level of pain that you may feel. Has anyone ever had a bad sleep, woken up cranky, found out there is no milk for your coffee THEN stubbed your toe.. how much does it hurt! Compare the level of pain to if you stub your toe coming back from the beach walking on hot bitumen with a car coming.. the pain is likely to be a lot less at the time because the brain has determined you need to cross the road quick smart and not stop instead!
“Nerves can get sensitive”… TRUTH – it is normal when you first injure yourself to experience soreness near the area of the injury and in other areas around the actual injury site. In the above example you may feel your foot or ankle is a bit sore! The ‘pain volume’ in the area has temporarily turned up – which is a helpful reminder to slow down a bit and avoid doing more injury. Usually the pain will settle quickly and we get on with doing our normal activities. Persistent pain is just acute pain hanging around longer than is helpful. Nerves then change in response and may become sensitive to light touch, cold and movement and interpret these normal things as dangerous.
“The brain can change and form patterns”… TRUTH – this is called ‘neuroplasticity’, a truly amazing feature of our brains. When a person repeats a particular movement or activity on a regular basis, the brain creates a pattern of nerve connections. If a movement is painful for long enough the brain strengthens the connection between movement and pain. For some with low back pain, the brain has joined the dots between normal sensations coming from your back, the movement of bending, the memory of injury and the experience of pain – and this unhelpful pattern is sensitised. Once sensitised, just thinking or preparing to do the movement is enough for the pattern to kick in and for you to feel pain. Therefore even though the body has totally healed, the movement still hurts.
In the next post we will discuss practical tips to help ‘turn the volume down’!
Have a great day and remember to move!
All the best,