A "Whole Person" Approach to Pain
We all occasionally experience pain, typically in response to an injury. Pain is our body's way of alerting us to danger and instructing us to avoid further damage. Whether the injury is a small one, like a paper cut, or something more serious such as a broken bone or damaged tendon, once the injury heals the pain typically disappears. But for some people, the pain lasts 3 to 6 months or longer. This is when "acute" pain becomes "chronic" pain.
what causes chronic pain?
First, it is important to understand how much of our pain is determined by the brain's functioning. When pain occurs, the brain interprets and modulates these sensations like volume controls for the pain, either dialing it louder or quieting it down. We can become "hypersensitive" to pain. This occurs when the brain has the pain volume constantly turned up. This does not require repeated injury; it can happen as a result of just one really painful experience! When anxious, the brain might request “more information” from the peripheral nerves, ordering them to produce more signals in response to smaller stimuli. It does this in an attempt to protect us from danger, but the result is devastating to our quality of life.
There is recent evidence that the peripheral nerves can even physically, chemically change, perhaps in response to brain requests, tissue conditions, or both. To extend the analogy, this isn’t just twiddling the volume knob, but changing the equipment, changing the signal before it even gets to the “amplifier.”
The following video is a TEDx talk given by Australia’s Lorimer Moseley, Professor of Clinical Neurosciences, titled "Why Things Hurt." This talk is a must-watch for anyone with chronic pain. Professor Moseley is a funny and extremely entertaining speaker, but his message is an important one for anyone with chronic pain to hear.
Once we are injured, painful sensations become more severe, and some sensations that might not be painful to others reach a threshold of pain for the sensitized brain.
Brain research over the past decade has shown us where the volume controls are, how they work and how to restore the volume to normal. Briefly, we normally register pain primarily in the sensory-motor cortex of the brain. However, the hyper-sensitized person not only activates the sensory-motor cortex when experiencing pain, but also the limbic system and an area called the cingulate cortex. This entirely changes the way we experience pain, adding distress and rumination to our physical symptoms.
Addressing hypersensitization and other factors:
Fortunately, there are ways to learn to control and re-regulate the volume controls. Just as your brain may have learned to "turn up the volume" of your pain, you can teach it to turn the volume back down. But learning to calm your brain's hypersensitization to pain is not always enough ...
We will also work together to address the physical inflammation that chronic pain sufferers experience. We all know inflammation on the surface of the body as local redness, heat, swelling and pain. This is a vital part of the body's immune response, bringing more nourishment and healing activity to a site of injury or infection. But when inflammation persists or serves no purpose, it damages the body and causes illness. Stress, lack of exercise, diet, genetic predisposition, and exposure to toxins can all contribute to such chronic inflammation. Chronic inflammation, sometimes called persistent, low-grade inflammation, happens when the body sends an inflammatory response to a perceived internal threat that does not require an inflammatory response. The white blood cells swarm, but have nothing to do and nowhere to go, and they sometimes eventually start attacking internal organs or other necessary tissues and cells. Systemic, low grade inflammation is an invisible culprit which increases tissue tenderness. Your body chemistry has to be balanced for optimal health and well-being. You might not even be aware that certain lifestyle habits and choices over time are resulting in metabolic imbalances which promote a more inflammatory environment. Research has shown unequivocally that this system-wide inflammation is fundamentally involved with cardiovascular disease, depression and pain. For the person in pain, this amplified quality of tenderness increases pain levels. Tenderness might also lower your tolerance for therapies and exercise which are needed to restore function and reduce pain.
We can help you understand the causes of inflammation, make needed adjustments and changes to lifestyle, and utilize proven supplementation to restore balance and eliminate excessive tenderness. But there is still one more area we need to consider ...
You might think that addressing both your brain's and body's responses to injury is enough, but certain attitudes, beliefs, thought patterns and life habits may be allowing your pain to maintain its grip. Think about it: Does fear of experiencing even more pain and suffering keep you from fully participating in prescribed therapies? Do you have a negative perspective towards life and living? Do you have an urge to numb the pain, opening a path toward substance abuse and addiction? We may need to address any, or all, of these factors.
Or have you allowed yourself to become satisfied with a "consolation prize?" While your rational, thinking mind wants nothing more than to be free from pain, your subconscious may be sabotaging you. "Consolation prizes" are indirect benefits of continuing to experience pain, such as a new level of personal attention that you were missing before the pain started, or escape from unpleasant situations or crushing responsibilities. Ironically, if your basic nature is that of an optimist your subconscious may have grabbed on to the consolation prize that comes with your pain as a way of coping with its disabling nature. We might need to work on finding a way to get those needs met without the pain - in other words, we'll have to convince your subconscious that it's "safe" to turn that volume knob back down again!
This is why we call our approach to treating chronic pain a "whole person" approach -
it requires us to address not just the way your brain and body are functioning, but also psychological and personality constructs which might be affecting your recovery.
Recovery from chronic pain is an active process which requires your commitment and participation.
We can teach you effective techniques to move your mind and body in a healthier direction.
Call us to get started!