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Pain. It is a common phenomenon experienced by all living creatures. Whether you skinned your knees falling off a bike, snapped a bone in a sports game or experience the incessant grinding pain of arthritis, you probably do not think fondly about pain. But what if I told you pain is an important and often misunderstood part of life?

Without pain, living would be a lot more dangerous. Pain is like the fire alarm in a building, unpleasant and uncomfortable, but preferable to getting trapped inside a burning building. Initially, pain alerts your brain that something damaging and potentially dangerous is going on somewhere in your body, so that instead of participating in your typical daily activities like bungee jumping or scuba diving, you slow down and protect the injured area. The problem occurs as your brain takes command and perpetuates the pain.

Every millisecond, thousands of sensors in your skin, muscles, bones, tendons and ligaments send messages to your spinal cord about what is occurring in their little sector of your body. These messages exist for a short time then, poof! they disappear. If enough of the same messages pile up in the spinal cord at the same time, the message is sent up to the brain at which point you become aware of the sensation of a dog licking your hand or frigid rain hitting your forehead. The message sent from your tissues to your brain is then compared to your past experiences, your current mood, your environment and all the other messages from all the other sensors to create a picture of what is happening in your world. If your brain determines you are in danger, you experience pain as your body’s way to coerce you into action to get rid of the danger.

Injury produces inflammation which attracts special cells to repair the wound.  The inflammation causes danger messages to be sent to the brain to alert it to the injured condition of the tissue. As the injury heals, the inflammation reduces and the pain decreases. If the pain persists after the tissue has healed, the pain no longer indicates that your body is damaged, it indicates that the brain wrongly thinks you are still in danger.

Chronic pain like arthritis or fibromyalgia physically changes your body so that the level of pain no longer reflects the amount of injury in the tissues. The receptors in the spinal cord become more sensitive so it takes a smaller pile up of danger messages before the message is sent to your brain. The brain also becomes more sensitized causing a constant flood of hormones that heighten your fixation on the pain and cause the pain to become linked more to the thoughts in your brain instead of the conditions of the initially injured tissue.

 

Generally, there are two common ways people attempt to deal with chronic pain. On one path, the No Pain No Gain squad try to stifle the pain and forge ahead with extreme activity eventually leading to further injury. Treading down the other trail, the fear-avoidance crew become stuck in a vicious cycle of avoiding activities and movements for fear of pain thereby decreasing their health and quality of life and further exacerbating the pain. Although both tempting, neither route leads to the wellbeing that comes from understanding, respecting and responding to pain.

The first step along the path to wellbeing is to understand that your brain uses pain to protect you, but that protection mechanism often gets carried away and mistakenly convinces you that your injury is not healing. Once you realize that hurt does not always equal harm, you can take back control over your brain by gradually reintroducing your body to movement. Find your baseline, or that level of activity right before the pain becomes unbearable and debilitating, whether that is 5 minutes of walking or doing one load of laundry. Each day add one more shirt to the load or walk one mailbox farther than you did the day before, until you reach your pre-pain activity level. As you exercise your physical body through safe movements, your brain will remodel itself- decreasing those anxiety amplifying hormones and danger messages.

For an entertaining and easy to understand explanation of the neuroscience of pain check out Explain Pain by David Butler and Lorimer Mosely.