You may have heard the term “chronic pain” used in healthcare. Chronic pain is experienced by 1 in 5 Australians and can be quite debilitating. Normally, tissue healing from an acute injury takes anywhere between 4-8 weeks, depending on what structures have been affected. After you have experienced an acute injury, your therapist will encourage you to gradually return to your normal activities, sport and work duties. Chronic pain, now more commonly termed “persistent pain”, is pain that continues for months - even years! - after the body’s tissue healing process has been completed. Some people with chronic pain will insist that there MUST be something wrong with that area of their body, due to the pain they are experiencing
We know that pain is a feeling that is produced by the brain – it is a protective response to tissue damage. Sometimes after an injury has healed, the brain continues to produce these pain signals even though there is no longer any tissue damage – we still don’t know exactly why this occurs. We DO know that most muscles, ligaments, tendons, bones, discs etc are healed as much as they can be after 3-6 months. Therefore, ongoing pain being produced by the brain is less about structural damage in the body and more about the sensitivity of the nervous system – this is a very complex system!
To attack chronic pain, you essentially need to retrain the brain and nervous system. There are a number of factors that that affect the nervous system and may be contributing to your individual pain experience. Here are a variety of things to consider when developing your plan to manage chronic pain:
- Diet and lifestyle – consider the things that might be contributing to a sensitised nervous system, such as smoking, alcohol consumption and how much exercise you are doing (or lack thereof)
- Look at all the things that were happening around the time the pain developed – many people with pain make links between a worrying or stressful period of life and a worsening pain picture
- Medication can help initially to “get going”, but only to a limited extent – it is very important to taper and cease medication
- Surgery is not always the answer – especially in the case of chronic pain, where we know tissue damage is not the source of pain
- Thoughts and emotions - pain really impacts on peoples’ mood and stress levels. How are these thoughts and emotions affecting your nervous system? It is important to find strategies to reduce stress and “wind down” the nervous system – these strategies are different for each person.
- PHYSICAL ACTIVITY AND FUNCTION – get moving at a comfortable level without fear of pain under the guidance of your therapist. This is ultimately one of the best ways to remind the brain that there is no longer tissue damage and that all of those ongoing protective pain signals are not required anymore.
PAIN COMES FROM THE BRAIN AND CAN BE RETRAINED. Having a broad perspective is very important, as chronic pain is a very complex process and the things that contribute to it are slightly different for each individual. Seek the guidance of your physiotherapist to develop a good management plan.