Do you suffer from chronic pain? Are you feeling frustrated and hopeless because nothing seems to help? You are not alone. Chronic pain is a real issue for many people, but it doesn’t have to be an insurmountable one.
What is Chronic Pain?
At Trimetrics, we understand the difficulty of living with chronic pain, and our goal is to provide relief through effective solutions. Here are some key points about what chronic pain is, its causes and effects:
- Chronic pain lasts longer than 3 months and may not have identifiable cause
- Pain can be both physical and emotional
- Acute pain serves a protective purpose but does not measure tissue damage
- Chronic pain does not serve as a warning sign or protection against further injury
One of the reasons that Clinical Pilates is so successful with the management of chronic pain is that it helps people to very much focus their attention as to how they are moving. This improved awareness alone can help people immeasurably!
The Cause of Chronic Pain
Chronic pain can be complex and multi-faceted, and it’s important to understand the factors that contribute to its development. The physical damage done by an injury is not always the only factor — psychosocial factors can also play a role.
For instance, anxiety, depression, lack of social support, and fear of movement all have been found to influence the development and maintenance of chronic pain.
Additionally, research has shown that people with higher levels of catastrophizing (thinking only negatively about the pain) experience more severe and longer lasting pain than those with lower levels.
Finally, it is important to remember that chronic pain is real, and it cannot be cured by simply thinking positively. It requires a comprehensive approach from the medical community, including both physical and mental health professionals.
It is also essential to seek out emotional support from family, friends, or support groups. With the right combination of therapies and interventions, we can work to reduce the impact of chronic pain on our lives.
Impact of Chronic Pain on Your Body
In fact, scientists can identify the very real physiological changes that occur in the nervous system that allow pain to persist. For example, imagine your nerves, all the way from your skin to spinal cord and brain, like a row of dominoes.
Normally, you must push a domino over, or in the case of a nerve, approach tissue damage for a signal to travel to the brain and be perceived as pain. When pain is chronic, it’s like just blowing air on them causes the nerves to fire; your dominos might even fall over randomly, all in the absence of real or potential tissue damage.
In the case of nerve endings, this is because those with chronic pain literally have more chemical messengers activating their nerve endings in addition to more nerve endings sprouting in an area that your brain thinks it needs to protect (Pinho-Ribeiro, Verri, & Chiu, 2017). In terms of what happens in the brain and spinal cord, you can think of chronic pain as a less friendly example of neuroplasticity.
In terms of what happens in the brain and spinal cord, you can think of chronic pain as a less friendly example of neuroplasticity.
Neuroplasticity is a popular buzzword, that describes the brain and nervous system’s ability to change over time. Historically, the brain was thought to be hard-wired and unchanging. Years of research has revealed that this is profoundly untrue, and that the brain changes significantly across the lifespan. When we repeat an activity over and over, it creates a pathway in the brain and nervous system. Think of riding a bike: in the beginning, it’s hard because the pathway in the brain and nervous system is new. It’s almost like you’re bushwhacking this new path. With practice, the pathway becomes clean, wide, and groomed—it becomes the path of least resistance, and now, you don’t even have to think about riding a bike.
Neuroplasticity is awesome when you’re trying to learn a new skill, but when it comes to pain, it’s sort of like the wonderful plasticity of our nervous system got a bit confused, and now we have created well-trodden pathway for pain to occur. In other words, you are not imagining or creating your pain, but the presence of unhelpful beliefs, fear of movement, stress, anxiety, depression, poor sleep etc. can and do lead to very real and measurable changes in your brain and nervous system which might mean pain sticks around—even when the physical body has healed.
Chronic pain is a debilitating condition that can take a toll on your body, mind, and spirit. Everyone experiences pain differently and for many people, it can be difficult to cope with the persistent sensation of pain.
When chronic pain persists, it can cause physical changes in the body due to the release of chemical messengers that activate nerve endings. This results in more nerve endings sprouting and increased sensitivity to touch or any other sensation. Additionally, neuroplasticity plays a role in persistent pain as repeated activities create pathways in the brain and nervous system that become the path of least resistance.
Each individual’s experience with chronic pain will be different and it is important to seek appropriate medical help to manage symptoms and maintain a good quality of life.
Physiotherapy and Pilates and other forms of rehabilitation can help to improve movement, strength and function. Ultimately, appropriate management of chronic pain requires an interdisciplinary approach that incorporates psychological, physiological and social factors.
These measures can be used as part of a comprehensive treatment plan which may include medications, physical therapy exercises and lifestyle changes such as stress management, mindfulness and sleep hygiene. It is critical to remember that there are many tools available to help manage chronic pain and by taking the time to explore all options, individuals can take an active role in their own health.
Recovering From Chronic Pain
Sure, your nervous system might be stuck right now, but what if learning that hurt does not equal harm, or that our pain does not mean our tissue is damaged, is actually liberating?
This means that even though it hurts to move the painful body part right now—we’re actually not causing any tissue damage by doing so—our nervous system just got its wires a little crossed. And if your brain can learn pain, it can unlearn pain—because of neuroplasticity!
It is likely very safe for you to do the movements or activities that cause you pain—and doing them gradually might be an important part of your recovery.
The timing of these movements or activities often depends on how ramped one’s nervous system is. Ideally, we’d like to bring down nervous system sensitivity with physiotherapy treatment techniques. As the nervous system calms down, exercise can begin to ramp upwards and we will hopefully and ideally begin to reverse some of the chronic pain changes that bring patients to our clinic.
Physiotherapists are trained to rule out anything nasty going on in the physical body, and once they’ve done that, you’re cleared to explore movement and the activities you love—even if it’s painful.
Chronic Pain Treatment at Trimetrics Physiotherapy
At Trimetrics, we understand that dealing with chronic pain can be difficult.
We want to help you find the solutions that will bring you relief and allow you to start living the life you deserve. Our team of experienced physiotherapists and Clinical Pilates instructors are here to provide comprehensive support and guidance for those struggling with persistent pain.
We know it’s hard, but we believe incorporating movement back into your life is essential for recovery. That’s why our team encourages a gradual approach to getting back into activities and movement in order to feel comfortable. We use a stop light analogy – green meaning no pain; yellow meaning some pain but tolerable or acceptable; red meaning too much pain and not tolerable or acceptable – to guide your activities while also teaching your brain and nervous system that movements are safe through repetition. Additionally, there is a great deal of research that supports a team approach to the management of chronic pain so it’s important to have the right people on your side when it comes time to making decisions about your health and wellbeing.
There is also a considerable amount of research that supports a team approach to the management of pain, so bringing on other health care professionals such as physiotherapists, counsellors, doctors, occupational therapists, and kinesiologists can help you to feel more supported on your path to recovery (Nicholas et al., 2019). Since pain is experienced by the nervous system, anything that calms the nervous system is usually helpful.
A little more background: there are two branches of the autonomic nervous system called the sympathetic and the parasympathetic response— the late Herbert Benson called them “fight or flight” and “rest and digest”, respectively.
Fight or flight is a helpful response that occurs when you’re in real or perceived danger. If a bear is chasing you, your fight or flight response will send blood to the muscles of your limbs, increase your heart rate and breathing, dilate your pupils, and so on, so that you’re able to get to safety.
The rest and digest response occurs when you feel relaxed. The heart rate slows, blood is redirected towards digestion, and the body can do important maintenance to keep you healthy (Benson, 2000). With chronic pain, the autonomic nervous system is a bit confused (Yeater et al., 2021). To balance this, you can do any activity that activates rest and digest. This could be a hot bath, meditation, deep breathing, receiving a massage, laying in a hammock, reading a book—the activity doesn’t matter, the lived experience of calmness is a trustworthy indicator that you have activated this branch of the nervous system (Amihai & Kozhevnikov, 2015).
That said, changing the nervous system is hard work, and you don’t have to do this alone. The support of a good health care team can make a world of difference in your recovery.
If you find yourself dealing with chronic pain, here are some tips from our team:
- Activate the rest & digest response by trying activities like hot baths, meditation or deep breathing exercises
- Exercise caution when engaging in potentially painful activities in order to reduce further discomfort
- Take advantage of support systems such as physiotherapists as well as Clinical Pilates instructors, Clinical counsellors, occupational therapists and your family doctor.
- Remember to relax: read a book in the hammock or listen to soothing music on your lunch break!
Our goal at Trimetrics Physiotherapy is to promote an active lifestyle even if it takes more effort than usual due to lingering physical issues. Through our patient care treatments and personalized plans for each individual case we work towards providing long-term relief from chronic pain in North Vancouver.
Together with our dedicated staff members we strive towards supporting patients throughout their journey towards recovery.
References:
Alhowimel, A., AlOtaibi, M., Radford, K.A., Coulson, C.E. (2018). The role of social support in the experience of low back pain disability and recovery: a systematic review
Osborne NR, Anastakis DJ, Davis KD. Peripheral nerve injuries, pain, and neuroplasticity
Ivarsson A, Johnson U, Podlog L. Psychological predictors of injury occurrence: a prospective investigation of professional Swedish soccer players
