According to the Journal of Pain, more than 30 percent of Americans are living with severe or chronic pain. That is over 100 million people!
What is Chronic Pain?
Chronic pain is defined as pain lasting greater than 3 months. There may be many causes. It may have started with an illness or injury from which you have long recovered. Despite years of searching and treatments, you may suffer chronic pain in the absence of any specific identifiable cause. If pain persists after an injury has healed, or the pain has no clear physical cause, it may be more appropriately classified as neuroplastic pain.
Let’s break that word apart. NEURO – of the brain. PLASTIC – as in plasticity. Chronic pain changes the brain. Many times, it leads to a triad of suffering including sleep disturbances and depression / anxiety disorders that further debilitate us, limit our mobility, and the ability to enjoy life. This can lead to further stress, vulnerability, and fear.
Chronic Pain and Your Brain
The first thing to appreciate is that all pain is processed in the brain. If we did not have a brain, we would not have pain. The number one job of our brain is PROTECTION. Our most primitive nervous system is wired to protect us. When the body experiences an injury, or even the fear of an injury, the brain generates the feeling of pain. This is critical to remember. Pain is a response created by the brain.
This is not to say pain is not real. All pain is 100% real, but how we perceive pain and how we respond to it is dynamic. Because of neuroplasticity, chronic pain changes the way our brain is wired, our response to that pain (or times when it is absent) can lay down a new wiring pattern in our brain.
I want to share some thoughts from a great book by Alan Gordon that I encourage many of our patients to read, The Way Out – Healing Chronic Pain. One of my favorite quotes, “Pain is like a conversation between your body and your brain. But as in any conversation, sometimes there are misunderstandings.” When pain is persistent, neurons that fire together, begin to wire together. Our brains begin to reinforce chronic pain even when the original danger, injury, need for protection is long gone. The pain response has now become a false alarm.
What if you knew before hearing a fire alarm that it was just a test / a false alarm? Would you respond differently when you heard it? If you knew you were safe, would you experience any fear around the sounding of the alarm? No, you would not. Fear is much of what fuels the persistence of chronic pain.
How to Self Manage Your Chronic Pain
So, the first step is searching and identifying “exceptions” to your pain. Let’s say your pain is frequently provoked when you sit longer than 30 minutes. Then, while watching a UT football game with buddies or having cocktails with your girlfriends, you realize you have been sitting for well over 3 hours with no pain. This “exception” is an episode when your pain behaves quite differently from how it would if it were caused completely by a physical problem. Many times, we will identify “vacation or inspiration exceptions” exposing the case for a neuroplastic component to our pain giving us a feeling of safety and hope upon which to build.
Somatic Tracking is the habit of exploring, observing, and describing your sensations without fear or judgment, but instead experiencing it through a lens of safety. Be the witness of your pain, not the victim. When your pain is low or not existent, notice it, embrace your control over it, appreciate the fact that it changes, and right now you feel good! When the pain is higher, stay calm, you are still safe and in control. At CHARM we teach our patients a variety of management strategies to employ when their pain level is higher, and we utilize a neuromuscular input approach to assist repatterning pain responses in the brain.
Pain science is complex, but there are answers.
Department of Physical Therapy
Center For Healing & Regenerative Medicine