Pain in a nutshell

 

Learning about pain is now recognised as a key factor in one’s recovery. Don’t worry, you certainly don’t need to become a specialist in neuroscience to achieve healing from chronic pain, but understanding a few basic principles is crucial.

 

So let’s make a start!

 

The common (and erroneous) way we tend to think about pain is very linear, a bit like this (forgive me if you already know better!):

 

We get injured ➟ the pain signal travels through the spinal cord ➟ it reaches the brain which registers ‘pain’.

 

Some of our experiences would fit in with that framework. Nice and easy. But some simply don’t.

 

For example, we can have an increase of pain without additional trigger. Or we can have a decrease in pain when we know we couldn’t have healed yet. Or we know the injury healed but it still hurts… Not to mention ‘phantom limb pain’… How does this make sense? A piece of the jigsaw must have been missing in this old paradigm of pain…

 

This linear way of thinking about pain is what makes us go from one doctor to another, one diagnosis to another, desperately searching for a cause to that pain. Some treatments sometimes help, sometimes they don’t, and some can even stop helping after a while….

 

As we keep on searching for a cure, focusing on a symptom and a cause, our fear about the pain tends to escalate. Ultimately, we’ve tried everything and nothing works. This understandably leaves us utterly hopeless…If we can’t find a physical CAUSE, we’ll never find a SOLUTION…

 

Thankfully, this is NOT true!

 

Here is what actually happens:

 

When we experience tissue damage (say we cut our finger), nerves at the site of injury called nociceptors are alerted of tissue trauma. These get activated even before tissue damage occurs and they send signals to the spinal cord with a message of ‘danger’.

 

These signals are not actually pain signals. They are simply signals alerting the brain that something is happening which could potentially damage us (if it hasn’t already).

 

So those danger signals are delivered to the brain. Once in the brain, these signals are combined with messages of hundreds of other inputs to the brain such as other sensory information, thoughts, emotions, past memories…

 

All of this combines and is used to assess how dangerous the situation really is.

 

If the verdict is that our safety is in danger, then the brain responds with danger signals, like PAIN. This unpleasant sensation will prompt us to take action to remain safe (by hurting us, it is sure to get our attention when it thinks we need to take action!).  

 

Pain is how the brain protects us from danger.

 

In other words, our pain is an assessment of our danger level and is nothing more than a protective mechanism.

 

Seems like a perfectly designed efficient mechanism! And in theory it is!

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But because that level is determined by the combination of so many factors, the level of pain does not always reflect the level of tissue damage only. This is the flaw in the system! There are so many ‘layers’ involved in this process that the brain can end up with a ‘faulty conclusion’…

 

If you’d like a bit of a break from reading this, you can watch this video by Lorimer Moseley who is a Professor of Clinical Neurosciences at the University of South Australia. He leads the Body in Mind Research Group, which investigates the role of the brain and mind in chronic pain. He also has a great sense of humour!

 

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Lorimer Mosely video, Why Things Hurt?

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Ok, but then you must be wondering what actually happens when pain persists?

 

Well with time, our pain system or autonomic nervous system can become over-sensitised.

 

This can happen at different levels along transmission to the brain.

 

The nociceptors themselves could have become more sensitive (so needing less stimulation to send danger signals).

 

It could be that the spinal cord is amplifying or dampening the intensity of the signals, which would alter the levels of signals reaching the brain, regardless of the stimulus.

 

Finally, the brain itself can modulate the experience of pain and combine with information from different input in an infinity of ways.

 

On top of this, the brain is capable of secreting a whole variety of chemicals such as endorphins (and lots of others) which can decrease or increase pain.

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This sensitisation that happens over time, and the formation of certain neural pathways, can be the cause of persistent pain or symptoms which continue long after an injury has healed or which could even have appeared without any injury ever having been there!

 

It also explains how insignificant stimuli such as gentle touch or even minor changes of temperature, can be perceived as painful for some individuals.

 

Thankfully, this ‘neurosciency’ way of understanding pain gives us new perspectives and a lot of hope!... 

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Basically, pain is an output of the brain to protect us from harm.

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So, the more evidence of danger is perceived (whether it’s a physical, mental, real or even imaginary danger!) the more pain the brain creates.

 

Logically, it follows that the more evidence of safety is perceived, the less pain we have!

 

Read this again!

 

Because there lies the solution…

 

This means that working on bringing feelings of safety to your brain, in other words, calming your hyper-vigilant nervous system and creating new neural circuits, a bit like new programs, will result in less pain, or even no pain at all…

 

YES!

 

We can consciously and somatically work on this and there is a huge variety of tools that can be used to bring back our hypersensitised nervous system to safety and harmony.

 

Any contributor to the creation of pain (past memories, relationships, unresolved emotions and trauma, thoughts, body tension, shallow breathing, even our beliefs about pain… and more!) can be identified, acknowledged, accepted and reframed.

 

The good news is they can be a doorway to reducing and eliminating pain. We can consciously work on repeatedly decreasing danger signals and therefore decreasing pain. Managing emotions, setting boundaries in relationships, healing trauma, amongst so many other things, can contribute to healing.

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Remember:

 

Pain is real (don’t believe anyone who suggests you imagine or exaggerate it!), it is also very personal (nobody experiences it in the exact same way), and it’s also normal! (Don’t expect to never have pain, pain is the reason you are alive!)

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The thing is that pain is not actually always an accurate evaluation of tissue damage. It’s just your brain’s assessment of the danger level. At that particular moment, in those particular circumstances. It will vary from person to person, day to day etc…

Pain is a very complex mechanism…

 

But we can choose to change the way we respond to challenges. We can alter the way these influence our brain’s assessment of safety or danger. This is how we can start to change our pain response ourselves.

 

It is possible to ‘unlearn’ our pain…

 

Here is a short video of Dr Howard Schubiner, explaining the formation of neural pathways in chronic pain:

 

 

Dr Howard Schubiner explains chronic pain

 

 

So this is how chronic pain and other persistent disorders (known as NPD or TMS) can actually be the product of prolonged periods of emotional strain. Our nervous system can get stuck in a high alert mode and physical or mental symptoms, or both, can be generated as a defence mechanism.

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I know, it all sounds a bit strange and simplistic at the same time…

But the truth is, we now understand the complex mechanisms involved in the making of those disorders.

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The nervous system can become stuck in hyper vigilance.

It’s comparable to a fire alarm which would keep on being activated in the absence of a fire.

 

It could be stopped each time, but unless the cause of malfunction was resolved, it will only keep on setting off unnecessarily.

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Do you think this information could help you start your mindbody healing journey with pain or any other medically unexplained symptoms?

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