Rethink Chronic Pain: A New Perspective on Managing Discomfort

“When people understand their pain, they hurt less.”

PAIN IS A MISUNDERSTOOD 5th VITAL SIGN
When I was a physical therapist, I viewed pain primarily as a number on a scale from 0 to 10. However, my experience at Boston Children’s Hospital, where I spent three years researching pediatric chronic pain, transformed my understanding. I engaged in extensive readings, watched teaching videos, and piloted new interventions for managing chronic pain in children. This experience taught me that pain is not just a symptom but a complex phenomenon that should be understood in depth.

From there on, I never looked at someone’s pain the same again.

Pain is unpleasant, but it protects you. It alerts you of danger and can make you move, think, behave differently, which is pretty vital for healing. But how do we know when it’s safe and not? How long should pain last? Why am I so hypersensitive? Why does healing take so long? Why can’t I be like everyone else? Will I always be like this?

There are many myths, misunderstandings, and unnecessary fears about pain. The majority of people including healthcare professionals don’t have a modern day understanding of it. This is unfortunate because if we understood pain better as providers, we can effectively teach ourselves and our patients a different way to think about it.

Chronic pain can persist even if tissues have finished healing

THE INFLAMMATION PROCESS AND PAIN

Any time we’re injured, even if it’s the daily “wear and tear”, our bodies begin to heal by taking care of it right away. The goal for our bodies is to always return injured tissue to a functional state ASAP. Whether your pain needs rest or movement, they are both beneficial when you understand the kind of pain you have.

Whatever injury we have, whether it is a gut, skin, muscles, joint issue, they all have a similar healing process to each other, just different timelines. They all go through an inflammatory process.

”But isn’t inflammation bad?”

No, not all inflammation is bad. We NEED inflammation in order to heal. Inflammation brings the appropriate white blood cells to takeaway and rebuild in the injured area. In a typical healing timeline, pain usually diminishes before tissues fully heal. Once the tissue is healed, it may not go back to the original state, but it is REPAIRED.

THE BRAIN’S ROLE IN PAIN 🧠

Being a human being means we consciously and subconsciously absorb many factors in order to make sense and find meaning in our pain. There’s a reason your first paper cut is the deepest; a reason the first ankle sprain from that run makes you more hesitant to take an unstable path again; a reason the last dumbbell shoulder press exercise you max’d out on caused the shoulder injury and you never return to it.

All these injuries will scar, will heal, will repair.

But when we’re in pain, our brains deliver a message to us: fight or flight. Safe or unsafe. Stop or go.

We draw on every piece of information that would allow us to determine how to handle it. And for the most part, we get over it and live on in our little dysfunctional world.

It’s only when we still experience the pain past the timeline of healed tissues, our “danger alarm system” becomes more sensitive and our brain is flooded with too many sensors than there should be.

And that’s no way to live.

So how do we fix it?

ISSUES IN OUR TISSUES

When an injury is fresh and new, you can experience acute pain, but when your pain experience prolongs past normal healing timelines (chronic pain), we tend to grow “issues in the tissues.” Pain can look like increased stress, anxiety, irritability, anger, and depression. Experiencing these feelings with pain can almost always involves the tissues, whether it’s inflammation, slow healing, or tissues that are deconditioned. But deeper than tissues, our central nervous system is the final decision maker whether or not we should be in pain.

So does this mean the pain is all in your head?

Yes.

Literally.

All pain is produced by the brain.

If we understand a small degree of biology and physiology of how our nervous system works, we can control what we’re experiencing. Isn’t that a relief?

PAIN & MODERN DAY SOLUTIONS
When I say “it’s all in your head”, it’s not to dismiss the experience you went through. The phrase truly embraces our mind. Our minds have an amazing way to teach our bodies how to self heal.

5 TIPS ON FINDING A SOLUTION TO YOUR PAIN:

1) 🧘🏻‍♀️ Holistic practices like yoga, qigong, tai chi, breathing exercises all promote two fundamental ideas: mindfulness and meditation. The practice of being aware of your body’s efforts and capabilities, but also the empty of everything to just “be” and “let go”, respectively. These practices are perfect for both active and passive individuals living with pain.

2) 🤸🏻‍♀️ Physical therapy, graded exposure therapy, mindful-based movement training, functional fitness, or specific strength/mobility/flexibility workouts all can promote better joint and muscle health, but more importantly, movement alone addresses the muscle and nervous system that originally work so hard to protect you from pain. These types of physical activities are perfect for those who have passively lived in their pain, or those who are putting their bodies into overdrive.

3) 🗣Talk therapy is also available for pain management. My two favorite types of psychotherapy are: cognitive behavioral therapy (CBT) to change your perspective and ease your pain, and acceptance and commitment therapy (ACT) to help you move forward. Both have an immense effect in breaking the fear-avoidance cycle.

4) 📚 Teaching yourself about pain. It is important to get to know what you don’t know, and sometimes we need a literal manual. My favorite go-to reading resource is “Explain Pain” by David Butler and Lorimer Moseley.

5) 💆🏻‍♀️ Lastly, acupuncture and/or manual therapies like massage. Acupuncture & manual therapy not only help with improving circulation and oxygenation to the tissues, but it can reverse engineer the way we perceive pain by retraining our nervous system’s pathways via the fascial tissue. Acupuncture can also improve the health of the body’s blood so oxygenated red blood cells and nutrients can be delivered to the tissues to reduce pain.

Instead of living with pain, let’s learn to face it so you can begin to live a life without limits.