CHRONIC PAIN IS REVERSIBLE

Welcome to the final article in the UNDERSTANDING PAIN series.

If you missed the first 3 articles, then I highly recommend you go back and read them first! You can find them here.

In today’s article, I will explain how chronic pain can be reversed.

Pain is real, but it’s not always accurate

When pain becomes persistent or chronic, the outcome is a pain response that no longer represents an accurate picture of true harm. The brain and body have overcalculated the level of threat and are sending pain messages, even though the original injury may no longer be problematic.

This does not mean that the pain is not real! Chronic pain is very real – it is just no longer an accurate interpretation of the injury.

Take this analogy: when you stare into the sun and then look away, you can still see white spots in your eyes. This is because the stimulus was so intense for the detectors that even after it’s gone, they are still firing.

It’s similar at a loud concert: your ears are exposed to such intense noise that after you leave, they often still ring for hours because the detectors were overstimulated.

It’s no different with pain: even after the injury or danger has gone, the pain response can keep playing on.

Pain is reversible: detectors and spines

Whilst the changes in the body and brain associated with chronic pain can seem complex and extensive, the good news is that all of it is reversible! You have approximately 37 trillion cells in your body. The life of a human cell is generally pretty short, and you are constantly replacing cells all the time.

The detectors that sense danger in your tissues only last a few days before they are replaced, so with the right training you can replace these oversensitive sensors with ones that are more accurate.

Your overexcited spinal cord can also be tamed, just like a well-trained puppy. Just as the brain can tell the spinal cord to be more protective and vigilant, it can also release chemicals that make it less sensitised and ask it to only relay danger messages that are really important.

This is how many drugs like paracetamol (called acetaminophen in some countries) work, but the body has its own chemicals that are even better.

Pain is reversible: neuroplasticity

Remember the word neuroplasticity? If you’ve forgotten, it means the brain can change and adapt, just like plastic. The various changes that occur in your brain that make you better at feeling pain can all be reversed.

You have about 80 billion brain cells, called neurons, and each cell can form thousands of links with other cells – the average brain has over 100 trillion connections. A famous scientist once said: ‘neurons that fire together, wire together’, which means the more often you practice something, the stronger the connections in the brain become.

How do we reverse it?

Reversing chronic pain can be a slow process with ups and downs, but it is very achievable. Under the guidance of a physiotherapist and other health professionals, some of the main strategies for reversing chronic pain include:

1. Gradual exposure to movement and exercise
2. Down-training the nervous system through mindfulness, massage, breath-work and relaxation techniques
3. Pain education
4. Eliminating inflammatory foods from the diet
5. Sleep improvement strategies
6. Improving body alignment and movement mechanics in the body
7. Mental rehearsal of painful movements

You now have an understanding of what pain is, how it occurs, why pain is actually very important, but how it can sometimes malfunction. Scientific research has shown that one of the most important factors in overcoming persistent pain is understanding the biology of pain. Congratulations – you’ve already accomplished one of the key steps to getting your life back!

Summary:

• Pain is an important protective mechanism
• The level of pain you experience is determined by how much danger your brain believes you are in
• It does not tell you about how much damage there is to your tissues
• Chronic pain is rarely an accurate assessment of danger to your body
• All of the changes in your body associated with chronic pain are reversible