Experiencing pain is a common human experience. It often plays a part in our early development and is crucial for our survival.(1) One of my earliest memories is a painful one, when a heavy swing set fell on my foot at school. Fortunately for me, that pain was short lived and I was able to play again.
However, for some people, acute pain persists for longer than normal. In New Zealand, it is estimated that 1 in 6 people live with persistent pain.(2) The reasons why people develop persistent pain is a complex issue, one that does not often have a single cause or a magic bullet to cure it.
Our understanding of pain, and indeed persistent pain has increased dramatically in recent years. Broadly speaking there are two types of pain. There is acute pain which is often associated with damage to the body (like my experience above) and resolves after healing has occurred and the body does not need protecting anymore. This healing normally takes up to 3 months.(3)
Then there is persistent pain, which lasts longer than acute pain and normally persists after an injury has healed. This pain may feel the same as acute pain but it does not often indicate ongoing damage. We know now that persistent pain is more likely, due to our brain and nervous system being on a constant state of alert rather that ongoing tissue damage.(1, 3)
I liken this to a person setting their car alarm to a high after it was broken into but the alarm has become stuck at a very sensitive level, even after they have repaired the damage and moved it away from a bad neighbourhood. This alarm may go off when somebody walks past the car, even though there is no danger.
Understanding why the alarm is stuck on a high setting and how to reduce this sensitivity is not easy and takes time and effort. Some general tips to getting started are:
- Knowledge is power: Gaining a better understanding of pain is crucial to starting the journey of gaining control over persistent pain. Studies have shown that combining normal physiotherapy care and pain education results in superior effects.
- Set goals: Setting goals helps you focus on important things you want to achieve, which can shift your focus from the pain.
- Get moving: General exercise such as walking or aqua jogging can help reduce muscle weakness, get increased blood flow to the body and brain, and improve your mood. Talking to a physio can help identify what types of exercise and how much is right for you.
- Turn down the alarm’s sensitivity: there are often simple things we can do to reduce the sensitivity of our bodies alarm system. From specific stretches that are performed by yourself to hand on treatment which can help you along the path.
- Get help: It is important when dealing with persistent pain that you don’t go alone. Have a team of people to help you from your family and friends, to the GP and physio.
If you need help dealing with persistent pain, TBI Health will customise a plan that will help you. Just get in touch with a clinic near you and we’ll sort the rest.
- Louw A, Puentedura EJ, Zimney K, Schmidt S. Know Pain, Know Gain? A Perspective on Pain Neuroscience Education in Physical Therapy. journal of orthopaedic & sports physical therapy. 2016;46(3):131-4.
- Dominick C, Blyth F, Nicholas M. Patterns of chronic pain in the New Zealand population. The New Zealand Medical Journal (Online). 2011;124(1337).
- Louw A, Puentedura E. Therapeutic Neuroscience Education: Teaching Patients about Pain: a Guide for Clinicians: International Spine and Pain Institute; 2013.