We all experience pain. Pain is a part of life and a normal response created by our nervous system. It isn’t pleasant, but the ability to know when something hurts is a good thing! We can act accordingly to stop whatever is causing the pain, seek help if needed, and avoid it from happening again in the future.
Your body contains 45 miles of nerves and more than 300 individual nerves, all connected like roadways. When your body experiences a noxious stimulus (an event in which you are injured) it sends sensory signals from the site of injury to the spinal cord, which transmits a message to the brain. It is a common misconception that these signals travel up to tell your brain there is pain. In actuality, it is the brain that takes the sensory information, processes it, and determines the pain response. Pain is a decision made by the brain, and the bigger the threat, the bigger the response.
Pain generally goes away, but in some people, these nerves can become hypersensitive after injury and difficult to calm down. In the book, “Why Do I Hurt,” by Adriaan Louw, PT, PhD, he compares our nerves to a home alarm system. Events like a broken window are big and loud enough to alert you, but if your nerves are sensitive, something as mild as a leaf blowing by the house may stir up an alarm response. This can make normal day-to-day tasks that were once painless, difficult to perform.
Research shows that when we are having pain, different areas of our brain light up. Areas such as our focus, fear, memory, motivation, and stress response are involved and communicate with each other to determine the degree of danger. As a result, the brain produces pain levels it deems necessary in order to protect you. Since pain is our perception of a threat, emotional factors such as anxiety, stress, and depression can play a role in increasing excitability in our alarm system and influence heightened pain responses.
In physical therapy, our job is to educate you about your pain and your injury. Sometimes the unknown can provoke worry. One of the biggest steps in reducing chronic pain is removing the apprehension of uncertainty and replacing it with knowledge. Understanding the neuroscience of your brain, and how you think and process pain, plays a huge part in desensitizing your alarm system.
We are also big believers in movement and exercise. Pain often inhibits your movement without you realizing it, so staying active is key. Touching the area of pain to desensitize it, moving the body part within its range of motion, or even the simple act of walking can create a calming effect on the nerves. Louw emphasizes that you don’t need to run marathons or climb mountains to achieve the benefits of exercise. Studies show that 10-20 minutes of brisk walking is all you need to get your heart rate up. Increased circulation of blood and oxygen throughout the body helps to calm down nerves. It can also reduce stress levels, mood swings, depression, and fatigue.
Goal setting is another great way to inspire change and get you motivated. If pain is limiting you from cleaning your house, cooking, or performing other important activities of life, start by making a list of short term goals. Don’t let pain halt you from doing the things you need or want to do. Break it down into smaller tasks that are manageable and less daunting.
Another modifiable behavior that can reduce pain is getting enough sleep. The effects of sleep deprivation can manifest into physical and mental changes, such as weight gain, depression, weakened immunity, and increased pain. Set a consistent bedtime and shut off lights or electronics that stimulate the brain.
The truth is, everyone’s pain is real and true. However, sometimes people experience pain that is produced due to sensitivity and not injury. The good news is that it is measurable and can be changed. Understanding that pain is your brain’s perception of danger is a big first step in taking charge in your recovery. To learn more about the neuroscience of pain, check out the book, “Why Do I Hurt” by Adriaan Louw, PT, PhD. He describes the science of nerves with relatable, approachable, and easy to understand examples/metaphors that pertain to everyday life.