Let’s take a look at the perception of chronic pain.
Pain is weird, brains are weird, they don’t really know what’s going on in their own body; they have an opinion, but opinions are not the same as facts.
First of all, there is no nerve that carries signals of “pain” from the body to the brain. The messages that nerves actually carry are things like “hot” “cold” “pressure” “stretch” or even “harm”. The brain takes these messages, and interprets them within the context that past experience provides.
Pain, therefore, is a highly subjective, personal experience. It is easily altered by experience, hopes and fears, and even the language used when giving or receiving explanations.
It is supposed to be.
Pain isn’t a report on what is going on in your body – that’s the job of the nerve messages. Pain is a protective mechanism; it is supposed to make you act appropriately to the report on what is happening to your body. Pain can under-react (ignoring harmful information due to lack of experience); it can be appropriate and proportional (if you sprain an ankle, it’s supposed to hurt – to stop you doing something silly on it), or it can over-react (that chilli isn’t actually dissolving your tongue in a vat of acid).
Pain is a construct of the brain; and brains can get… bored… and that stinging nettle rash that was nothing much, can become agonising when your brain has nothing else to think about. Pain can be learned – to prevent you from doing the same thing again. Pain can be made actively worse by worrying about it (that stinging nettle rash again, or concern about someone you know who had something similar) as you rehearse the sensation of pain.
This all means that we can feel pain in a part of the body that has no damage, most especially, we can continue to feel pain in a part of the body which used to be damaged, but in which the damage has healed. That pain is absolutely real; it’s just that the brain became so good at feeling pain there; it is now misinterpreting other signals as being painful. Essentially, it has become phobic.
So what can we do about it?
Well, we can retrain the brain. We can reassure the body that actually, these movements, these touches are okay. We can learn to think about the pain differently; to challenge the brain’s beliefs about what is happening. Gentle manual therapy can calm the brain’s over-reaction to stimulus. Finding things that don’t hurt (movements and exercises), and repeating them often, can push back on the boundary for what is felt as pain. Cognitive behavioural therapy (CBT) can change the way we think about the pain, and learn how to more appropriately interpret the signals arriving from the body. Even just reading this post can potentially help you understand, and feel differently about pain.
#Pain #PainScience #PainPerception #Neuroplastic #CBT #Tewkesbury
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