1. Pain is always real no matter what’s causing it
At any given time on earth, 20% of people have pain lasting longer than 3 months^1. When pain persists longer than the expected healing stages, it’s because the brain has subconsciously come to the conclusion that your body is threatened or in danger. The goal for treatments with chronic pain will be to discover why the brain has come to this conclusion ^2.
2. There are many potential contributors to pain
As research progresses we are learning about the increasing complexity of chronic pain which we can understand using the biopsychosocial model. This model speaks on the multidimensional nature of pain. The pain experience can be likened to the overflowing of a cup^3. The water that fills the cup can include physical, emotional, or social stressors. Our capacity to tolerate stressors is like the cup. Not only can we decrease the “water” or stressors in our lives, but we can also build a bigger “cup” or resiliency to those stressors.
3. Pain is about protecting your tissues Pain is normal and allows us to survive. It is like an alarm turning on to motivate us to take action. For example, when our hand gets close to a fire, we feel pain and will move our hands away to protect ourselves. Also, if we sprain our ankle, it will hurt to initially move it which is our body’s protective mechanism to minimize walking so it can heal.
4. Pain doesn’t mean there is tissue damage How can amputees feel pain in a limb that no longer exists? And why have we discovered bruises on our bodies but have no recollection of feeling pain from it? Or how come young healthy 20 year olds can display wear and tear or ligament tears on X-rays and MRIs but have no pain? Pain can be a weird alarm system that goes out of proportion at times by “overprotecting us” and thereby lowering our thresholds for things which make us sensitive to pain.
5. We are bioplastic (ie. our nerves and tissues can adapt for good or bad!) In chronic pain the body does too good of a job to protect our tissues, so the body develops habits that can make us guarded, anxious, and fearful of movement. If you’ve been told by a healthcare professional that it is harmful to bend your back or reach your arms above your head, there is a high chance this belief will increase your sensitivity of pain with those movements. However, just as we develop bad habits in life, it is possible to develop good ones as well.
6. Understanding pain will help us apply knowledge to everyday problems
Unfortunately there are many misunderstandings and unnecessary fears about pain. Learning about the physiology of pain can reduce the treat level of pain. With less threat signals, there will be less activation of all our protective mechanisms in our body including the sympathetic, endocrine, and motor systems. Knowing how the body works will change the way you think about your problem so you can begin to practice self-management recovery strategies.
7. Active treatments are better than passive
Not only is exercise critical for tissue health and repair, but the restoration of movements will help improve quality of life as you gradually return to meaningful activities. Taking action and responsibility for your health builds resilience and coping strategies to allow us to adapt and tolerate the stressors in our lives.
Patrick Chiu, Registered Physiotherapist
Patrick Chiu is a Chronic Pain telephysiotherapist with extensive post-graduate training. Book an telephysio (online physio, virtual physio) appointment today to learn more about chronic pain and how to manage it in your daily life.
^1 Blyth, FM. and et al., (2001). Chronic pain in Australia: a prevalence study. Pain. 89:127-134.
^2 David S Butler & G Lorimer Moseley (2013). Explain Pain. Noigroup Publications
^3 Greg Lehman (2017). Recovery strategies - Pain Guidebook