Is my pain all in my head?

Ongoing pain is a stressful, depressing and frustrating experience that many Australians are experiencing. At the clinic we help people control, reduce and in many cases completely remove pain that has been plaguing them for so long. How we do this varies from patient to patient, as pain is an extremely complex problem. This blog will serve as a discussion about pain to help you understand your pain, or perhaps to help you empathise with those who have pain.

Pain is an unpleasant and normally unwanted sensation given to you by your nervous system normally when something needs to be changed in order to avoid damage. For example, if we put our hand on a hot stove, we receive pain as an indicator that this is causing us physical harm and we need to remove our hand from that stove.

OK so the pain alarm bell has been rung and I’ve stopped the activity – in some cases that is not the end of the story.  Let’s take a common example, chronic back pain. I’ve had a strain in my lower back, or perhaps a disc bulge. I’ve had some pain as a result of the injury and it’s been a month since I hurt it. I’ve been resting, getting some massage, and trying to avoid hurting it any further. It is not improving. Another 6 months pass. My back is still not getting better, in fact new pains are popping up, and overall, I am in more pain than I was even just after I got hurt. I’m not lifting anything, I’m being very careful, and I’m following the instructions of my medical professionals (unfortunately not good ones).  I’m also on a fairly high dose of pain killers. Why am I not getting better?

This is a really common situation we see daily, and the reason is most commonly very simple. Your back injury is better. It has healed or stabilised. The tissue that was damaged is no longer the complete cause of your pain. BUT you’ve been laid up for 8-12 months, you haven’t been exercising, you haven’t been moving, and when you have you’ve been moving with compensations because you were scared to load or bend your back. You’ve probably put on 5-15kg, your diet and mental health have all taken a hit due to high stress, pain, and lack of sleep. Your nervous system has become highly sensitised as is hasn’t been exposed to any loading since the injury, and now it hurts to do EVERYTHING!

Can you see where this is heading? Ongoing pain is a vicious cycle that will not improve on its own. The initial injury is rarely the cause of the ongoing pain. For example, if you took a healthy person, and then made them stop bending their back, never pick anything up from the floor, never twist, interrupt their sleep, and ruin their diet – do you think they would be in pain. YES. Would they be depressed? YES. In fact, many chronic pain sufferers are just that. A product of lifestyle. And through no fault of their own. Chronic pain can start with an injury, it can start with a hard social or psychological situation, it can start from general sedentary lifestyle – the key is to understand the cycle and gradually trying to interrupt it.

The answer to pain and injury long term is not rest. Pain effects every aspect of your life, and so you must address every aspect of your life in order to improve it. The longer you’ve had pain, the further along this path you are and the more work needs to be put in. Don’t do it alone! Get some support. If you are in pain and you have tried everything (you haven’t) then come see an EP at Hunter Rehabilitation and Health. Start with getting moving, introduce diet, practice breathing, normalize your biomechanics, introduce load, and gradually increase all of this as your nervous system begins to desensitize. Your confidence begins to grow. The pain begins to decrease. You begin to sleep better. And you have taken back some control.  The best part about this approach? At the very least you will be a healthier, happier person who is not controlled by their pain.

The difference between an EP and many health professionals, is that an EP will look at you as a total being, not as an injury that needs to be fixed (that’s your bodies job). Injuries cannot be fixed by health professionals; good health professionals understand that they facilitate healing – they don’t cause it.