Before I tell you what could be increasing your pain, let’s look at a simple overview of the pain circuit and why pain is a vital sensation.
The basic pain process: Pain sensors (nociceptors) send messages through peripheral nerves from our muscles, joints, organs to our brain about pressure, temperature, and chemical changes. The peripheral nerves transfer this information to the central nervous system before being processed in the brain (thalamus, hypothalamus, limbic system, and sensory cortex). Our brains process the signal and decide whether to increase or decrease the intensity of the signal as it returns to the body.
Pain is important: The pain circuit allows us to process the data sensed by the peripheral nerves which allows us to save ourselves from detrimental damage or decide that the injury is minor. If the processing aspect was removed then we would have no control of how or when we feel pain. In a situation where moving in spite of an injury would save your life, there is a benefit to delaying pain sensation. Another benefit is not having the same reaction to a paper cut as a knife cutting your arm.
When the pain cycle is working correctly, it’s telling you to pay attention to something in your body which, in turn, allows you to take appropriate action to alleviate the origin of the signal.
Unfortunately, many people are told there is no injury found on an X-ray or MRI that explains the pain they describe. In many cases, this person is treated as a drug seeker or as if they are looking for attention. They are sent to a pain clinic to receive the only treatments they are told are available to them, medications.
Due to the prevalence of this healthcare issue, scientists have been studying chronic pain for several years. Much of what they have found says that the brain can be changed by pain. These changes can even be seen on a MRI. If pain was purely a “sensor -> production” system then the moment the sensor stop detecting changes then the pain sensation would stop. BUT the circuit has a processing aspect which adds a point that can receive addition data; which, has the ability to change the intensity of the pain sensation. Here are a few things that can cause the pain sensation to be elevated:
Emotions: specifically Fear, Anxiety, Stress
Pain is processed in the same part of the brain that processes emotions and memory. Therefore, when your peripheral nerve sends information to your brain at the same time it is processing high stress, anxiety, and/or fear, your brain could elevate the threat level of the pain. If this process happens long enough, changes in your brain can take place which leave a permanent pain circuit whether or not a signal continues to come from the peripheral nerve.
What does that mean? Emotional life situations or specific fears about your health can cause a state of hyper-awareness. Hyper-awareness is constantly looking for dangers and increasing the intensity (threat level) of all pain sensation as a way to save your life. Anxiety and stress have the same ability to cause hyper-awareness.
Example of this situation: The way your brain can intensify pain can be seen with simple annoyances, such as an itch on your face that you cannot scratch. After a very short period of time, that itch becomes extremely intense, consuming all your thoughts until you can finally scratch. If you have recently suffered a death in your family, a job loss, or are having family problems, think about how hard basic daily tasks can be to complete or how sensitive you are to what people say to you.
How to make a change:
Your body, including your brain, repairs itself at night while you are sleeping. Therefore, if you are not sleeping well your body is not going to work at an optimal level.
What is sleeping well? You should get 7 – 8 hours of uninterrupted sleep that leaves you feeling refreshed in the morning. If you wake up feeling tired then your sleep is not repairing your body from general wear in tear let alone an injury.
How to make a change: Sleep habits that can help are:
“Food is fuel” is a common saying but that is only half the reason food choice are important. Food supplies all the building blocks for tissue growth. Eating a variety of fruits, vegetables, proteins and grains ensures that your body has all the right building blocks for every hormone, muscle, enzyme required to mend your body.
How to make a change: If you have questions about the quality of your food choices https://www.choosemyplate.gov is a user friendly website with nutritional information. There are several private pay and insurance based nutritionists that can educate you on how to adjust your current diet.
Typically when something hurts, your instinct is to protect that area by not moving. If moving that body part causes the pain to increase, then not moving is a viable option. If you are able to move that body part, or any of the parts around the injury without increasing your pain then you should move those areas frequently. Movement will help reduce pain and improve healing by promoting digestion and increasing circulation.
Something to consider: As a toddler your “job” is to run and play. Moving around develops a body “map” in the brain. This “map” stays clear when we move consistently throughout the day; however, when we stop moving that map becomes smudged. This is a problem since your brain wants to know exactly where all your body parts are at all times. When your brain cannot find your right hand (because it hurts and it’s not being moved) then extra signals are sent out to your right hand in an attempt to find the hand. This cycle of sending more and more signals will magnify pain resulting in your natural protective instinct of not moving. This cycle get painful fast. The natural end of the hunt for the “missing” body part is your brain will assume that the body part is no longer attached. When you move your right hand it will feel like you are moving someone else’s hand.
How to make a change: Move what YOU CAN, when YOU CAN, as much as YOU CAN! That can literally mean walking around your house if that is more movement for you. Your Goals Physical Therapy can help improve your mind body connection, help you improve your pain free movement, and teach you how to self treat at home.
Thank you for reading Things That Can Increase Your Pain. This information is meant to give hope to anyone dealing with chronic or persistent pain. These are several treatment options with no side effects and they put you back in charge of your health.
The hope of this handout is to help people suffering with chronic pain find alternative treatments to the opioids they have undoubtedly been prescribed. That being said, anyone on opioids should consult their doctor prior to discontinuing their opioid prescription. Opioids are physically addicting and require a slow step down reduction of prescription to prevent withdrawal symptoms.
The conversation about pain medication and pain management can be very confusing and personal. If you or someone you love is looking for more information like what is in this post email Dr.Molly or pick the option below that works for you.
WE HELP ACTIVE ADULTS OVERCOME THEIR ACHES AND PAINS TO GET THEM BACK TO THEIR FAVORITE ACTIVITIES WITHOUT MEDICATION, INJECTIONS OR SURGERIES.
Dr. Molly McDonald