Understanding Pain: A Comprehensive Guide
As a physical therapist, I deal with pain on a daily basis in one form or another. I treat patients with lower back pain, shoulder pain, knee pain, neck pain, ankle pain… they’re all part of my daily work experience. Pain is so common for most individuals at some point in their lives, and yet the truth is that so many people don’t know the first thing about what it actually is. Pain is mysterious, and for many of us, it is actually very confusing. I’d like to offer some insight on pain, what it is, why it’s actually useful, and how we at Move Empower Concierge Physical Therapy help our patients get out of PAIN!
For most of us, pain is a very common part of our lives. No one really wants it, and once you experience it, you want to get rid of it. As annoying as it is, pain is actually useful for us. Firstly, it alerts you to danger! It protects us from injury or being injured. A good example of this would be slamming your finger in the door. Pain causes us to alter our movements, thoughts, and even behaviors — all of which is important for the healing of any injury. Sometimes pain can alert you to more serious problems. For example, severe headaches, shooting pain into the leg, or even a tooth ache.
What makes pain such a mystery is that it tends to surface in odd ways, at odd times, and it just won’t go away. The good news is that there is an explanation for this: our bodies are telling us that something is wrong, but not necessarily what is wrong.
Let me explain. When we experience pain, our bodies send signals to our brain from the body region that’s being affected. For example, If you step on a nail, your brain is told about it, and your foot is instantly sore. Similarly, if you scrape your knee, or jam your finger, it’s fairly easy to gather information about what happened.
But, what about when you have chronic lower back pain? You probably have wondered if the pain generator is due to a problem in the spine, the muscle, or the disc?
How about if your knee is so sensitive you can no longer walk comfortably? Is it the muscle, or is there a problem with the joint?
The body can be extremely odd about sending pain signals.
Take a soldier, for example. If he is shot during battle, he may not feel the pain of the entry wound until hours after the battle is over. Why? Because his body decided to delay the pain receptors to the brain so as to keep the soldier alert and responsive when it mattered most. And in many ways, our own bodies do the same.
How often have you had knee pain that surfaced a day or so after a run during which you twisted your leg? Or, how long after you tripped over the stairs did your back start to hurt? Pain can often be delayed, and frustratingly, this postponement often means we forget, or even mask, the cause of the pain.
It is this mysterious nature of pain that is such a big problem for many of my patients. On a daily basis I hear, “I just don’t know what I did”, or, “I really can’t remember hurting it”. Pain is so frustrating in this way — if you only knew why it’s sore! The truth is, it’s difficult to figure out what your body needs from you: did you pull a muscle, damage the cartilage, or just sit in an odd position? We often can’t know for sure, at least initially.
It’s clear to see that pain occurs when your body’s alarm system alerts the brain to actual or potential tissue damage. If it hurts, the chances are that something is wrong. An example of this would be spraining your ankle and the resultant pain afterward. The swelling and pain you experience is due to tissue injury, be it ligament, tendon, or bone.
But, what about when pain has stuck around for weeks, or even worse, for months or years? If there is pain there must be a lingering tissue injury, right? NO! Pain lasting several weeks and even months is considered chronic pain, and it is a different “animal” than the pain one experiences after a recent injury. Let’s take chronic lower back pain for example. You were outside working in the yard and bent over to pick up that last bag of grass and BOOM, you immediately feel pain. 4 weeks later you still feel this pain. Months go on, and still pain, even though it’s not as raw as it was after the injury, you still hurt when you walk, squat, or bend over to take off your shoes.
The difference here with chronic pain is that your injury to the tissue has healed. This healing took place within the first 6 weeks after the injury. The problem now is that your body’s alarm system has become more sensitive — the threshold for pain has been lowered. Now, simple movements hurt your back. Essentially your brain, has subconsciously concluded that the simple movements you do daily are a threat to your back.
So why is this? When pain has stuck around for too long, the body changes. Chemically and physically. The chemicals that cause your body’s nerves to transmit information to the brain about THREATS are more sensitized and eager to send messages of danger. This is also true of the receptors in your muscles, tendons, and joints. They too are on high alert. Even our thoughts will change. Patients with chronic pain will start to associate healthy activities and movements of the back, as “threats” because they always have pain when doing them.
Can this be changed?
Modern pain scientists say yes, and I’ve seen it with my own eyes. What needs to change is how the patient with chronic pain THINKS about pain. Said differently, You must RETRAIN the BRAIN on how it views pain. Step one is understanding that pain DOES NOT always mean harm.
In order to begin to make changes with chronic pain, people must change their thoughts on pain as well as the activities that cause them pain. Physical therapists are a great resource to help folks out of chronic pain.
At Move Empower Concierge Physical Therapy, our team of therapists treat pain as the symptom of an underlying problem. By approaching pain in this way, we make sure to find the root cause of the problem so as to clear up the tenderness and discomfort.
Sadly though, many medical professionals, treat the pain and not cause of the pain. Many patients will be offered pain pills and injections that essentially only mask the pain with the hope that the discomfort will ease in time. In my 20 years of experience, this just doesn’t work. The way we need to approach pain is NOT as a cause of discomfort, but as a SYMPTOM of a particular problem, whether it’s big or small.
At Move Empower Concierge Physical Therapy, our specialist physical therapists don’t just treat the pain. Instead, we find the root cause of the problem, utilizing treatments to help you heal by restoring proper strength and mobility that will allow you to get back to the pain-free active lifestyle you desire.
Are you or someone you know struggling with chronic pain? Are you frustrated by having to sit on the “sidelines” while everyone else in your family is having fun? Let’s chat about getting you back in the game with a FREE discovery session!