If there’s anything researchers have found through tireless work uncovering truth about pain, they have found that it is not an accurate measure of tissue health. Pain is in-fact a protector. An unfortunate truth about this pain is that millions of people have stubborn pain that will not go away.
Why won’t this pain go away?
To know that we must understand the body and its response to irritants. The brain creates this pain and sends signals to the areas of stress, telling us what needs to be protected and to remove the body from danger quickly. When people have pain for a long enough, the body becomes hypersensitive to the signals of pain even if the tissue has repaired itself long ago. This creates a perpetual cycle of flags that the brain hold up because it believes the tissue is still damaged.
Your pain can change quickly with your mood and small annoyances can set it off. You can become very sensitive to stimuli as if it is a snowballing effect. Before more research surfaced, people once understood pain as if it was something that was not real. The good news is we now how persistent pain happens and have an explanation for why it is very real.
Pain is never a one size fits all situation with clear-cut solutions. Sometimes pain can simply reduce by understanding it better. Knowing when it begins, what can exacerbate it, and how your body responds to various stressors is tricky. Sometimes during the healing process tissue will not act the same as it was before injury. Very similar to a scar that was repaired from an old cut. Tissue might not function the exact same way it once did but it can adapt and become stronger and less painful. We must take advantage of our bodies ability to evolve. Let’s take a dive deeper and see how chronic pain can be modified, stifled, and potentially removed.
We must focus on retraining the pain system by testing ourselves physically in a manner that is different from what we usually would. The brain is very plastic, meaning that it can change and respond constantly. Increased activity throughout the day can change the brain, causing previously painful things to become less irritating over time.
Various nerve pathways travel between previously injured tissue and the brain like traffic on the motorway. If the motorway has heavy traffic, you can imagine drivers (signals) get very annoyed. Angry drivers tend to bring their attitude home with them and this affect others. These constant nerve signals can cause a lot of hypersensitivity in the brain and tissue eventually leading to perpetual irritation with very simple movements that never bothered you before.
Understand your body.
You will know the pain system is becoming overprotective when the body feels more sensitive than it previously did. Keep tabs on how your body feels after performing simple to moderate tasks. Activities that are not usually painful can become painful when overactive tissue and hypersensitivity meet. Pain can spread to several areas or become localized from week to week which is an indicator that the movement system is under duress. Frequent muscle spasms might trigger difficulty with movement as another way to protect painful regions. These things tell your body that it is on alert. This by no means is a bad thing. It tells us retraining the pain system is a very important next step.
So how do you change chronic pain?
At Integrated Health Solutions, our doctors specialize in various services tailored to desensitize the tissue, nerve pathways and reaction of the brain to spicy stimulation. These services include dry needling, soft tissue mobilization, joint manipulation and exercise rehabilitation.
- Dry needling affects the tissue by damaging a few thousand cells, thus tricking the brain into sending white blood cells and other natural biological healing chemicals to expedite repair. In a simplified sense, this press is the reset button for the nervous system connection to the damaged tissue. Calming of the previously hyperactive tissue allows restructuring of function and pain sensitivity.
- Soft tissue mobilization allows for increased blood flow, muscle elongation and continued desensitization of knots (trigger points) in the tissue that cause dysfunction. When the tissue around a damaged region is more relaxed it allows for increased range of motion with decreased pain response.
- When tissue is more relaxed around a joint it gives our doctors the opportunity to perform a joint manipulation which is a precise, quick force applied to the region to help re-centrate the region contributing to perpetual pain.
- Once the manipulation or “adjustment” is performed, it is the appropriate time for exercise rehab to strengthen the tissue around the now-centered joint. Personalized exercise therapy will not only help the tissue restore strength it once had, but this will also allow for less pain during motion over the time of the treatment plan. The best part about treating the body with exercise is the empowerment it gives people when they are away from clinic. The freedom to move is liberating and encourages us to test the body even more.
How do I know when I am safe to move?
The most common reasons people don’t improve is because they avoid all movement that hurts. Some may also do everything regardless of how much it hurts until they can’t take the pain any longer. Make no bones about it, movement is the most critical pathway to recovery and people should know that it is almost always safe to move. Consider the stoplight method. Green light tells us that we are in light pain or pain-free and allowed to move within reasonable means without any setbacks. Yellow light means there is moderate to high pain in many forms of exercise and that one should proceed with heavy caution… Ideally with guidance from a health professional. Red light means the pain is debilitating and the areas requiring movement are highly unstable-Rest and low impact movement with professional aid is best at this juncture.
Hurt doesn’t equal harm.
As covered previously, injuries heal and body tissue adapts amazingly well to the demands of various lifestyles. Unfortunately, they don’t always heal quickly or perfectly. If an injury happened months ago then the body has most certainly carried out a certain level of the healing process already. Don’t be discouraged if pain persists. If you can walk with pain, it is likely that you are not damaging the tissue. In-fact motion will increase the durability and capacity of the tissue function. Exercise brings blood flow to the areas of the body required to move. Increased blood flow means expedited healing, so we should take advantage of this and move more often!
Not convinced that you should feel confident about movement?
Several studies have revealed data that disc bulges in the back are incredibly common in people without back pain. This is so common that scientists believe these bulges are not abnormal but a common part of aging. Fact: 50% of 40 year olds with ZERO back pain have a disc bulge-Brinjiki et al (2014).
What about rest and sitting for recovery?
An old adage from doctorate school comes to mind. To rest is to rust. The body has a recovery system that is incredible. The trick is you must help it occasionally. With chronic pain, quick fixes and gimmicks don’t exist. Retraining your body with an anti-inflammatory diet and targeted exercise consistency is key. Rest with overprotective pain system can lead even more protectiveness. Your body will adapt to a stationary lifestyle so if you activate the tissue you will become stronger and much more resilient to injury. Use exercise to rid the body of an overprotective system.
Don’t just take our word for it.
Johns Hopkins Medicine journal formulated 7 ways to treat chronic back pain without surgery and the top 4 treatment processes involve:
- Exercise therapy
- Stretching and flexibility
- Postural training
- Testing the limits of pain tolerance
- Aerobic exercise
- Core strengthening
2. Mindfulness and meditation
- Sensory deprivation
3. Diet alteration
- Shaving off inflammatory foods
- Maintaining a healthy weight
4. Lifestyle modifications
- Accepting current physical limitations
- Pacing yourself to avoid exercise burnout
- Noting when hurts and what helps your symptoms
- Decreasing and eventually ridding smoking habits: Nicotine is a scientifically proven pain enhancer that also delays healing.
Mindset and action!
Don’t forget that stress and anxiety can loom large in the recovery process. Clearing the mind with meditation and affirming your journey positive mindfulness helps considerably. Surrounding yourself with active family members and friends will encourage your movement and give you a boost of dopamine and serotonin (feel good chemicals from the brain). Set a reminder in your phone to stretch, get fresh air with a walk or do passive tissue massage with a ball or foam roller. Communicate well with the boss or work coordinator about your situation to help them understand your recovery process. Sitting at the desk for hours on end can set back healing, so be sure to give the body some micro-breaks for movement throughout the day to stay on track.
Content provided by Dr. Parker Grundman