The truth behind how pain can persist

We should view pain as an alarm. Alarms are meant to motivate you to do something to protect yourself. How loud the alarm is, or how many alarms are going off, are not good indicators of how much protection is needed.

The truth behind how pain can persist

Pain is helpful after an injury initially, as it serves a necessary purpose in helping you to avoid loading the injured area too much. However, this protective response can then ‘overdo’ its job and persist past expected healing time. In these instances, pain is not as helpful. This does not mean that the pain is not real – all pain is real! It simply means that your perception has changed, and your body has become used to being in pain. It’s almost like a smoke alarm still going off long after the firefighters have put out the fire and gone home.

Think of a sniper in the Vietnam War who has spent years isolated in the jungle, shooting at the enemy – but he’s lost his radio. Nobody is able to reach him and tell him that the war is over, so he is still hiding in the jungle. There is no actual danger anymore  but he doesn’t know that, so his perception is that there is still danger.

There are many potential contributors to why pain is experienced and why pain can persist – such as mental health, poor sleep, fear of movement, and previous experiences.


So, how can previous experiences shape pain?

Imagine you are walking through the bush, and a snake bites you on the leg. You experience agonising pain, but you still make a good recovery and there are no lingering physical effects. Later that month, you are walking along the same bush trail, but this time you are a little more hyper-vigilant and fearful given your previous experience. You stand on a stick, which kicks up and brushes your leg – how do you think you would react to this? The stick is not actually dangerous, but given your previous experience the context has changed, and there is now a perception of danger!

When living with persistent pain, it can be normal to feel down, have a sense of hopelessness, and feel like your body is weak. You can work on flipping this mindset around by understanding that pain is an alarm and that your body is strong, robust and adaptable. There are many actions you can take – one being exercise –  to expose yourself to stress and allow your body to positively adapt. We have lots of ways to help change the current pain trajectory and calm down the over-protective ‘alarm system’. Speak to your Exercise Physiologist to develop a collaborative plan to restructure the nature of your ongoing pain and disability.

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References:

Lehman, G. (2017). Recovery strategies: pain guidebook. Retrieved from http://www.greglehman.ca/recovery-strategies-pain-guidebook

Moseley, L, & Butler, D. (2015). The Explain Pain Handbook: Protectometer. Adelaide, South Australia: NOI Group Publications.

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