We bump our elbow on the bench, touch a really hot surface or step on a piece of lego and we feel pain. Sounds simple right?

Unfortunately pain can be much more complicated than that. Believe it or not pain doesn’t come from your elbow that you just bumped or the foot that just stepped on the lego.

Pain all comes from the brain, it is actually an output from your brain based on how much danger it thinks you are in(1). Pain is our brain’s way of protecting us from doing anything that it believes will do more damage.

Take the example of bumping your elbow on the bench. Specific nerve cells in the elbow will send signals to the brain and immediately you will feel a lot of pain. The brain’s alarm bells are going off because it is trying to figure out what has happened.

Then, relatively quickly the pain will reduce back down. There may be a bruise or swelling but the pain will be a fraction of what it was immediately after.

This is because your brain has processed the information and decided that we are not in any danger. Yes there may be some tissue damage and inflammation but it isn’t a matter of life or death.

That is an example of acute pain. A very useful sensation in keeping us safe and protecting injured tissues.

Another type of pain is chronic pain. Chronic pain is much less useful, in fact chronic pain serves no purpose at all.

Chronic pain by definition is pain that has lasted longer than 3-6 months, this is the time most tissues in the body take to heal (2).

Chronic pain occurs when our nervous system becomes overly sensitised and starts sending more and more signals to the brain to tell it we are in danger (2). Usually however there is no danger at all.

Once our brain receives these signals, it sends pain signals to the area as it believes there is something wrong.

This can continue and cause the brain itself to become sensitised and cause it to send pain signals to nearby areas in the body too.

Because of this sensitised state, the amount of pain people feel usually correlates very poorly to the amount of tissue damage (2).

Now, to some people this might sound like the pain is all imagined or in their head. Yes the pain is in their head, but so is all pain. Their pain is definitely not imagined, it is just different to pain that comes from a cut or a sprain. Chronic pain is more like a bad habit that has been learned over time.

There are many different aspects that cause a brain to do this. Previous experiences, emotions, our beliefs of what has happened are all factors in how much pain we experience.

What can we do about chronic pain then?

There is no quick fix. Research shows that learning and understanding about pain is one of the most effective tools. (3)

Exercise is another big part of getting better- encouraging your body to move again and having the confidence to know you aren’t doing any damage (4).

If you suffer from chronic pain and would like to know more, here are a couple of videos that can help you understand it better. Otherwise come and see one of your friendly osteopaths to discuss how we can help.

Lorimer Mosely- Why things hurt

Understand pain in 5 minutes


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References

1. Ingraham, P. (2019). Central Sensitization in Chronic Pain. Retrieved from https://www.painscience.com/articles/central-sensitization.php

2. Louw, A. (2013). Why do I hurt?. [Annapolis]: [OPTP (Orthopedic physical therapy products)].

3. Michaleff, Z., Maher, C., Lin, C., Rebbeck, T., Jull, G., & Latimer, J. et al. (2015). Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial. Physiotherapy, 101, e1001-e1002. doi: 10.1016/j.physio.2015.03.1865

4. Merzenich, M. (2013). Soft-wired. San Francisco, Calif.: Parnassus Pub.

5. TEDxAdelaide – Lorimer Moseley – Why Things Hurt. (2019). Retrieved from https://www.youtube.com/watch?v=gwd-wLdIHjs

6. Understanding Pain in less than 5 minutes, and what to do about it!. (2019). Retrieved from https://youtu.be/C_3phB93rvI