Understanding & Managing Persistent Pain

Everyone agrees that pain is a universal human experience. We also know that pain is produced by the brain. This includes all pain whether sharp, dull, strong or mild, and no matter how long you’ve had it. This article discusses persistent, or chronic, pain and provides strategies on how to manage it.

If you have pain for only a few weeks or months it is called acute pain.  Acute pain is common with tissue damage, say from a back injury or ankle sprain.  Generally you will be encouraged to stay active and gradually get back to doing normal activities, including work.

If your pain has been present for three months or more, it is called persistent or chronic pain.  With this type of pain, tissue damage is not the main issue. In Australia chronic pain is a big problem, with one in five people experiencing it at some point in their life. It can also be unclear how to best manage it.

Having a brain that keeps producing pain, even after the body tissues are restored and out of danger, is no fun. Some people say they still feel like there is something wrong. But as long as anything sinister has been ruled out, we know most injuries fully heal within three to six months.  So any pain felt after this time has to be explained by something else. What we do know is that after this time ongoing pain is less about structural changes in the body, and more about the sensitivity of the nervous system.  In other words, it is complex.

Because chronic pain is complex we need to figure out what is causing it.  We also need to retrain the brain and nervous system.  To do this, it is helpful to look at things that affect the nervous system and may be contributing to your individual pain experience. In other words it’s important to look at persistent pain from a broad perspective. By using a structured approach and plan to do so, it is less likely anything will be missed.

Let’s start with the medical side.  Taking medication can help, but only to a limited extent.  It is the more active approaches that are necessary to retrain the brain. So while using medication to help control the pain can help, they can mostly be tapered and ceased with time.  Surgery may also not be helpful.  So if you’re thinking of surgery it is best to get a second opinion.

Next, it is helpful to consider how your thoughts and emotions are affecting your nervous system. Pain impacts people’s lives, and this can have a huge affect on your mood and stress levels. All those thoughts and beliefs are brain impulses too. But you can learn ways to reduce stress and wind down the nervous system. This helps with emotional wellbeing and can reduce pain.

The third area to consider is the role of diet and lifestyle. It turns out our modern lifestyle might not be so good for us. What we eat and how we live can contribute to a sensitized nervous system. Start by looking at things like smoking, nutrition, alcohol and activity levels. If there are any issues these things can go on your plan.

There’s also value in exploring the deeper meaning of pain. When looking back over the time pain developed, many people can make useful links between a worrying period of life and a worsening pain picture. Recognising deeper emotions can be part of the healing process.

Last, but by no means least, is physical activity and function. From the brain’s perspective getting moving at comfortable levels, without fear and where the brain does not protect by pain, is best to gradually restore your body’s tissue.

To sum up pain: It comes from the brain and can be retrained, and when looked at from a whole person perspective gives you lots of opportunities to begin.

So, get a helping hand if you need it! Set a goal and begin! And if you would like to discuss how we can help further, please call and make an appointment at any of our Physiotas clinics.

About the Author:

Natalie Claudio is a Remedial Massage Therapist at Physiotas in Launceston.

Natalie graduated as a Remedial Massage Therapist in December 2010 and is a member of Massage and Myotherapy Australia. She provides high quality remedial massage services for a diverse range of clients, working within a dynamic team of allied health professionals.

Natalie offers deep tissue, sports massage, trigger point therapy, muscle energy techniques, pregnancy massage, integrative fascial release, joint mobilisation, corporate and relaxation massage. She also assists patients with meditation techniques for health and well being.