Chronic Pain

Chronic pain – All in my head?

January 6, 2014 • By

Your central nervous system plays a massive role in ongoing and chronic pain, Here we will discuss why patients are often told pain is in their head and how you can help it train your brain.

chronic pain - is it in my head? - explained and how to fix itPain is subjective, meaning every single person responds to and feels it differently. This is because the pain receptors (nocioceptors) around your body sense something going on and send the signal up to your brain. How the brain processes/perceives this signal depends on a combination of things:

  • Gender: Hormones can affect perceived pain.
  • Family: How you were taught to react to pain as a child.
  • Past experience: The degree of pain felt in the past and how traumatic it was changes how your brain reacts to pain, for example.
  • Mood: Your mental state can affect how you feel pain. Things such as sadness, depression can increase pain perception. Be aware that it can also happen the other way around!

This is why there is a huge variety of pain tolerances in our society – the varying upbringings and experiences that occur in everyone’s lives.

Chronic pain and you:

Chronic pain is pain that exists after an acute injury has healed or after the normal tissue healing time (generalized to 3 months). For one reason or another reason, the injury does not fully heal (this could be because of some overlooked contributing factor but often for unknown reasons) and the nerve fibers continue to send pain signals up to the brain. With all these signals shooting up to the brain telling it that there is something bad going on, the brain begins to accept these like they are a normal thing, improving the pain pathways, making them more efficient. This results in more pain. Also along with this the chemical messengers that are used in the pain network increase and over time the threshold (how much stimulus is needed) for pain lowers.

Put more simply, with the continued and increased pain signals the brain gets used to them, think of them as normal and becomes more sensitive to them so a smaller and less intense stimulus is needed to feel pain! This is called Central Sensitization.

This is why people are often told that “it is in your head” and yes your brain is definitely contributing to your pain because it has become more sensitive but ALL PAIN IS REAL.

So how can we mitigate the effects of chronic pain and reduce the pain? Try some of these steps:

  1. Relax: Stress and tension will increase pain so practice relaxation techniques – these are easy and can reduce pain by up to 50%. There are multiple options here, find something that works for you! e.g. relaxation.
  2. Keep active: Physical activity boosts endorphins (natural pain-killer), boosts the immune system and helps get your body stronger!
  3. Get serious about rehabbing yourself – find out what you need to do from a Physio that will find your deficits and get to it, regularly and you will improve.
  4. Find appropriate healthcare providers e.g. a doctor that specializes in pain management, a psychologist and a physiotherapist that not only looks at your injury but you as a person.
  5. Eat healthy and don’t over indulge (no overeating, excess alcohol or tobacco consumption).
  6. Drink enough water: Females over 2 litres and men over 2.5 liters.
  7. Get enough sleep: Infants need about 16 hours per day, teenagers need about 9 and for most adults 7 to 8 hours a day is the best amount.
  8. Positive: Get social support by going to events etc that you enjoy(sports, music, dancing etc.) and keep positive people around you, not negative.

Remember all pain is real and everyone experiences it in a different way and most importantly it is NOT something you have to live with. It can be helped and improved.

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