ADVICE

Chronic Pain

Did you know that ALL pain is caused by the brain? That’s whether the pain is short and sharp or a constant, dull ache.

The British Pain Society’s research shows that up to 40 percent of the British population is living with chronic pain at any time, of whom 14.3 percent live with pain that is either moderately or severely disabling. It’s estimated that back pain alone costs the NHS around £12.3 billion a year, with an eye-watering cost to the economy.

When we fall, and sprain an ankle we expect to feel pain because there is a physical, explicable cause. However, sometimes pain becomes chronic and outlasts the original tissue damage. Here the primary cause of the pain is not physical.

Experiencing pain once the injury has healed feels like real physical pain – it IS real pain, except that there’s no longer a physical injury. Most injuries heal within 3 – 6 months so ongoing pain is something altogether more complex. I don’t pretend to fully understand it but I do know that current pain science theory takes a broad view on treatment.

Consider how we “feel” pain. If a painful stimulus, like a pin prick, is applied to the body, sensory neurones in the skin, called nociceptors, send messages to the brain warning of a potential threat. The brain responds by acknowledging the threat, creating a pain sensation and sending messages to the threatened limb which moves away from the stimulus. Sometimes, different factors cause the threshold at which pain is felt to decrease and we become hypersensitive to pain in that area, leading to chronic pain.

What is the best way to treat chronic pain? Too often we are given painkillers and left to our own devices. Painkillers can be helpful in the acute stages of injury, by keeping us moving, but long term they do not work. Surgery is sometimes offered as an option, but you should always seek a second opinion – surgery should be a last resort.

Looking at the external factors that affect the nervous system can give clues to the cause of the hypersensitivity and chronic pain: –

• Going through a highly stressful period increases symptoms of physical pain; there’s no doubt that emotional well-being leads to a reduction in pain.

• Sometimes the start of pain can be attributed to an emotional period of life. Talking therapies can help if there is clearly a link between the two.

• Diet and lifestyle also impact chronic pain. Modern lifestyles are often physically inactive, our diets calorific but nutritionally poor and alcohol frequently used to de-stress. All these worsen chronic pain.

• After a trauma in which injury and pain occurs, the body adapts its movement patterns to protect the injury. Sometimes however, the patient develops exaggerated fears of further injury. They begin to avoid performing certain actions, as simple as bending down to pick up something form the floor, or loading and unloading the washing machine. They develop a fear of performing these actions and if they attempt to do so, their brain causes actual pain. The altered movement patterns fail to return to normal once the injury has healed, exacerbating the problem. Part of the healing process in these cases must be retraining the brain to allow the body to perform the feared activities.

If you are one of the many who suffer from chronic pain, don’t accept it as part of life and don’t rely on medication to control it. Seek help, make small adjustments to promote emotional well-being, set small goals to introduce more physical activity to your lives and most importantly, don’t give up!