What is pain?
Pain is the way our body responds to danger, whether it is the danger of a torn muscle that your body is trying to protect or the danger that your body “thinks” you are in if you do a particular exercise or activity.
Pain is very difficult to diagnose because no one thing causes pain. Pain is produced in 3 ways. 1. A signal (not a pain signal. This signal could be something like: the sensation of being touched, the sensation of a muscle tearing, the sensation of sitting straight, etc) is sent to the spinal cord and the brain. 2. The brain determines whether this message is a “threat” or not, based on our beliefs about pain and our past experiences. 3. The brain sends a signal to the area where the first signal came from with an order, such as feeling the need to change position, or feeling the need to remove your hand from the hot stove, etc.
This order sets off a chain of reactions based on what your brain determined. If it thinks it’s under threat of harm or further damage it will send out a pain signal to tell you to stop moving, it will send out orders to tighten up muscles to prevent too much movement and it will even send off an order for your body to produce some swelling in the area.
This is great when we really are under threat of causing further damage but sometimes our brain decides to send that message when we are not in danger of hurting ourselves. Sometimes it will think that our sore back for instance is going to get worse if we lift a heavy box, because we all know someone who has lifted something and hurt their back. So our muscles tighten, and we experience a little bit of pain because that’s what our brain has decided is the best thing to avoid pain, not because lifting the box caused us any harm. Doesn’t make sense right? Our brain causes pain to stop you from hurting yourself. One of the most common examples is when we are sitting for a long time and our back muscles get a bit achy. In a normal situation our back muscles send a message to the brain saying that the muscles are sore and need to move and be stretched. When things go wrong , the brain interprets this as “the muscles are sore and are probably being damaged” and instead of sending a message relaying the need to move and change position, it sends down a signal to tighten the muscles (which causes more pain) and also sends a signal to set off pain in your back. Double whammy. So even though you are getting a pain response, most of the time you are sore, but safe.
So why does our brain cause pain to avoid hurting ourselves? It’s not because you are crazy or weak or “abusing the system” as some people think. It’s because of neurochemical changes that occur in our brain, nervous system and muscles. The longer we experience pain, the better our body gets at producing pain. Just like a bodybuilder repeats exercises in the gym to strengthen his muscles, our pain gets stronger the longer we experience it. Among many other important neurochemicals are two sets: the feel good chemicals and the feel bad chemicals. The feel good chemicals are dopamine, serotonin, oxytocin and endorphin. These chemicals promote happiness, healing and well being. Our brain releases these chemicals when we do something that makes us happy or that is good for us such as sleeping or exercising, but they don’t stay in our system for long. So we need to continuously do things that are good for us or that make us feel safe and happy. There are also the feel bad chemicals such as cortisol and adrenaline. The brain releases these chemicals when we are sad, afraid, stressed or in pain and it makes these feelings worse and also causes muscle tightness, inflammation, stomach aches, constipation or diarrhoea, fatigue, sleeplessness and decreases the effect the feel good chemicals have on us. It doesn’t take long for us to create bad habits of increasing the bad chemicals and decreasing the good chemicals, and it snowballs from there. The good news is that you can force your body to change old habits and return to producing more of the good chemicals and less of the bad. The bad news is that it takes around 45 days and can be quite challenging. Just like alcohol or drugs, pain is very addictive to your body and the brain. So kicking the addiction is hard and painful. But once your body has given up on pain you will feel amazing so it is definitely worth the hard work. Doing things you enjoy, sleeping well, sensible exercising, good eating, good posture, socialising and decreasing the stress in your life are all great steps to take to reverse the cycle of constant pain. Ask your physiotherapist for more information on how to beat your pain as everyone is different and what works for one person, may not necessarily work for everyone.