You have pain: What you need to know
***A quick note, that it is my intention to post every Thursday in a Segment that we can call….”Therapy Thursday” (it took my hours to come up with that name)***
Your mind is about to be blown…
A quick Google search defines pain as “physical suffering or discomfort caused by illness or injury.”
Seems simple enough, right? Let’s take a look a further look.
The Stanford University School of Medicine, Department of Pain Management describes pain as the way that your brain interprets information about a particular sensation that your body is experiencing. Lorimer Moseley, a prominent pain scientist, defines pain in the following way. “Pain is produced by the brain after a person’s neural signature has been activated and concluded the body is in danger and action is required. The truth is, even though I will try to simplify it, pain is an extremely complex phenomenon and it is important to know a few things about it before a panic attack sets in.
First, it is important to know that pain has a purpose. Pain is a good thing. Pain is your body’s way of telling you that you may be in danger. Without this signal, your hand could burn on the stovetop without you knowing it. Living without pain would be a terrible thing.
Second, research shows that the amount of pain you feel has no or nearly no relationship with the amount of damage that may exist, particularly in low back pain. Many times, people come to therapy in extreme pain with nearly normal X-Ray’s and MRI’s.
Third, your brain is very plastic. This means that it can change and it can change often. Long-term pain often changes the way your brain has mapped your body, painful areas smudge together with other areas. Luckily for you, the same changes that may help keep you in pain are able to help you get out of pain.
Without complexity, let’s go through the steps to pain:
Step 1: Sensory message enters spinal cord
Step 2: Released chemicals reach the threshold to be sent to brain
Step 3: Brain gets message from spinal cord
Step 4: Brain constructs a picture with all available information, including similar experiences under similar circumstances. Everyone experiences pain differently and many different areas of the brain have been identified to signal pain
Step 5: Brain determines whether or not you feel pain
Step 6: Brain sends a signal down your spinal cord, back into the area which the original signal came from, and alerts your body to “danger” in that area.
Let’s also look at all of the areas of the brain that can be “lit up” with someone in pain. This “neural signature” is different from person to person.
Premotor/Motor Cortex: organizes and prepares for movement
Cingulate Cortex: Concentration/Focus
Prefrontal Cortex: Problem Solving/Memory
Amygdala: Fear, fear conditioning, addiction
Sensory Cortex: Sensory discrimination
Hypothalamus/Thalamus: Stress response, autonomic regulation, motivation
Cerebellum: Movement and cognition
Hippocampus: Long term memory
Last for now, all tissues have a normal healing time depending on age, health status, diet, hydration, and numerous other variables. If pain persists beyond normal healing times, your pain trigger is likely related to something other than your original injury.
If you’re injured, having pain or would like to attempt to prevent an event that could lead to pain, get started with your PT/CPT team’s consultation, corrective techniques, and strength and conditioning program.
Are you hurt or are you injured?
This little phrase is one that I heard repeatedly throughout high school and college sports. If you’re hurt, you can play they always said. But if you’re injured, you should sit out. You likely don’t need to stop training due to some sort of pain. You will likely need to make some changes to your program in order to maintain high level training To me, this sounds like, is your pain something you can deal with or should you have a medical professional check it out…
Is it time to get your aches and pains checked out?
If you have an extra 15 minutes and are interested in how someone who talks funny teaches people about pain, check out this video.
Explain Pain. David Butler, G. Lorimer Moseley. 2013
Therapeutic Neuroscience Education. Adriaan Louw, Emilio Puentedura. 2013