Step 4 Understanding Pain

The more I learn about chronic pain, the less I know. Chronic pain is so complex, and the research so vast, it is impossible for one person to know everything there is about chronic pain.

Below are different pain experts explaining pain. My special interest is in stress because it is the cause of 70% of chronic diseases and early death. Chronic pain causes severe stress on the brain and body and stress causes chronic pain. 

Understanding Pain is vital to pain management. Take the time to learn about pain. These videos offer an understanding of pain and are worth watching all the way through to the end. Some information is repeated, but in each video something new is discussed to explain pain.  

Here is a short video explaining nerve cells and neurotransmitters.

Neurophysiological Pain occurs along with structural causes of pain, like osteoarthritis or other pain conditions. Treating Neurophysiological pain can be the main reason for pain. Rate your likelihood of neurophysiological pain using Dr. Schubiner’s list from his book, Unlearn your Pain. Take the Quiz.

The Video below takes a while to load, but a really good video.

This video takes a while to start, practice your ventral vagal breath while you wait.

Rachel Zoffness, in her Pain Management Workbook, speaks about all the factors that influence pain:

Biology: Genetics, Tissue damage, Body not functioning well, Inflammation, Hormones running amuck, Diet, and sleep. There are more.

Social: Interactions with family and friends can be positive or negative. Lack of funding can influence care, as can environmental stressors, cultural problems, and lack of community resources. 

Psychological: Our thoughts, beliefs, the meaning we give our pain, our emotions, and our coping behaviors all affect pain. 

Another pain expert has some other explanations for chronic pain. I don’t agree completely with everything in that there are more complicated issues. The biology of pain is not mentioned here very much. Have a look at the BioPsychoSocial chronic pain approach, but do look at the videos because they deal with the psychosocial part of pain. 

Alan Gordon’s Podcasts, Tell Me about your Pain and Nicole Sachs (below) tips on Journal Speak mentioned in her you tube video are some of the helpful tools for managing chronic pain. Lower alarm in your brain by using other techniques in this link Inflammation and Alarm

Acute pain is a warning of danger. Something is wrong. Your body reacts to protect itself. If your finger touches a hot surface, pain is the warning. Your body reacts by removing your finger from the hot surface.

When you have pain for more than 3 months, we call it chronic pain. At the 3 month mark, the danger has passed. In Canada, 25 to 30 out of 100 experience chronic pain. If you have a certain area that is painful, take a look at Types of Pain to see if you recognize the reason for your pain. There are videos explaining pain and types of management. 

If your pain is in many places of your body, it means your Fascia is involved. The more symptoms you have, the more likely you have fibromyalgia or myofascial pain syndrome.

Chronic pain changes how you experience the world and how you see yourself. Questions you make ask: Why me? Why now? 

Pain can stop you from doing activities you used to enjoy. It may change how you think of your future. It can make you feel hopeless. You may even wonder, Why am I here? What is the point of my life?

Chronic pain interferes with thinking and concentration. It affects your memory. It is hard to focus when you have pain. It can become the center of your life. Perhaps you can hardly think of anything else. It exhausts the body and the mind and can cause fatigue, anxiety, and depression.

Chronic pain can make you doubt yourself. You may even feel as if you are weak – even though people living with chronic pain have to be strong to survive it. Sometimes you may think the pain is all in your head. It is not! Have a look at another explanation of chronic pain.

Why do some people develop chronic pain?

Our life experiences shape us. How we see the world influences our pain. Here are some videos explaining the importance of past injuries. Trauma and Chronic Pain.

There are more ways to injure your body than stepping on a nail or picking a fight with someone who is bigger than you are. Even sitting on the sofa produces pain. If you sit for more than twenty minutes, muscles in your body send messages to your brain warning your brain of danger. For the lucky 70% of us, these messages are ignored by the brain. If your alarm system is set too high, you can feel even the smallest amount of pain. 

Chronic Pain overwhelms the brain and causes severe stress, fatigue and brain fog. 

Chronic pain is a disease, not a symptom.

Our brain becomes different when we have chronic pain. These are the areas that regulate and affect pain:

Cerebral cortex – place of higher thinking. Provides a conscious pain response.

Limbic system – regulates emotions

Prefrontal cortex – regulates attention

Above a video on the thalamus – the brain’s relay station

Anterior cingulate cortex – determines if your pain is unpleasant

Insular cortex – dial for pain intensity. Receives and sends messages dealing with emotion.

Somatosensory cortex – tells you where the pain is in your body. The sensory receptors in your body (nociceptors) collect information about temperature, pressure, and chemicals.

Primary motor cortex – reacts to painful stimuli, moving your body away from danger.

Hippocampus – stores pain memories.

Amygdala – Where we feel fear and other emotions.

Understanding pain can help you feel less threatened by it. The extent of chronic pain is not a reflection of tissue damage, says Rachel Zoffness and other pain experts. These sites in the brain provide a context for your pain. They inform your behaviors. The information comes from where you are, whom you are with, what is happening, past experiences and memories, thoughts beliefs and expectations.

Wonderful quotes from Rachel Zoffness:

Indications of danger make pain worse, while credible evidence of safety reduces pain. Hurt and harm are not the same.

Here is another wonderful website with tips on how to understand pain. Flippin’ Pain.

Here are more resources from Flippin’ Pain

Here is another explanation of chronic pain. 

The good news is that the brain is plastic. This means that it can change. The same way chronic pain caused changes in your brain, so following proven techniques can change your brain’s wiring so you experience less pain and cope with the pain better. This wonderful ability is called neuroplasticity.

The more you practice, the more the brain improves in managing pain. Movement and exercise especially help to dial down pain. Gradually exposing yourself to triggers of pain, like movement, touch, activity, can desensitize the brain, reducing pain.

The pain dial can also be adjusted by improving your reactions to stressors and by working on finding ways to improve your mood. Paying attention to your pain and your emotions is very important in turning down the dial.

The brain can change. It takes effort and motivation, which is particularly hard when you have chronic pain, physical or emotional, but the reward can be life changing. Not everyone will benefit, but if you do, your life could improve dramatically. This is a very reputable program that can help you change your brain. 

Medicine is more than pharmacy. Medicine can help, but are we spending our dollars on the end point of medicine – the complications of diseases that have preventable causes?

Linn Getz has a wonderful lecture you can view under Articles and Talks

She talks about Molecular Medicine – Where the body is seen as a machine (Bio-) and Meaning and Experience – Psycho-Social Medicine – Humanistic Sciences.

Biology – We can develop pain because of our genes or because of diseases and injuries. Western medicine focuses very much on the biology of disease.

Psychosocial Medicine? Our environment and our interactions with ourselves and others influence health tremendously. You will notice I spend much of my time on stress and disease. How we cope with our pain – emotional and physical – and how we interact with our environment affects us and those around us.

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