Archive for June 2019

How Pain Works Part 2. Pain is a Warning system

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Over the last 5-10 years we have learned A LOT about pain and how it works, but a lot of this is completely foreign to most people, so we’ve decided to produce a series of articles to help people actually understand their pain and what is going on… Firstly because KNOWLEDGE IS POWER! And secondly because understanding why you feel how you feel is empowering and de-threatening (as they say – just knowing is half the battle)

This is part two of a 5-part series on learning how pain works!

PAIN IS A WARNING SYSTEM

The experience of pain is part of your body’s and brain’s warning and protective system. We’re incredibly smart when it comes to trying to stop our selves getting damaged or dying, so we have a whole host of systems built in to try and avoid us coming to grief.

Now often we think that pain = damage, but we now know that pain often occurs long before any damage actually occurs.

Did you ever get a “Chinese burn” from another kid at school? Hurt didn’t it? But any damage to your arm? Not at all.

Or a better example – have you ever touched something hot, and it HURT! So you automatically pulled away (something called a withdrawal reflex – another clever way we are designed to stop hurting ourselves).

You check your hand… but it looks ok. It hurt for a few seconds, and that settles down within 10-30 seconds. Lucky you!

This is a great example of pain without pathology, or damage. The pain you experienced (immediately and possibly severely) was a STRONG warning that you are at high risk of damage if you don’t change your behaviour (touching the hot thing). Because of the experience of pain you have managed to completely avoid any tissue damage at all (clever you). Your pain served as a perfect warning system.

Even when you have an issue, your experience of pain can still be part of your body’s protective systems. Your brain (and your body) will actually try to actively give you more pain to stop you doing things it may think are potentially more damaging.

As an evolutionary example: Say you’ve sprained your ankle, so you’re not able to run as fast as normal. This means that if you and your Neolithic buddies are out hunting woolly mammoths you could be more likely to get injured and killed (not to mention potentially do more damage to your ankle). By creating pain, which makes you unable to participate, your brain is actively trying to stop you getting killed.

This may be a bit of an extreme example, but it’s true. When you have an injury, there are chemicals released by the body (in the inflammatory fluid) that actually make your receptors more sensitive (so they will send signals to your brain that things that wouldn’t normally tell you there is pain NOW tell you there is pain.) Part of the injury process actually tries to make it MORE painful for you.

Luckily nowadays we don’t have to fight for our lives, so a lot of this is fairly redundant. But that doesn’t stop it from happening. So, more pain doesn’t necessarily equal more damage. If anything, it just indicates more warning from your brain and body.

So when it comes to our aches, pains and injuries… It’s good to know that pain is your body’s rudimentary warning system that something bad MIGHT happen, not that there is already damage. Knowing this helps us know that if sometimes our pain is worse, it doesn’t mean you are MORE damaged. It might just be your brain paying more attention for some reason.

Stay tuned for Part 3 of our ” How pain works”  series – and learn how your brain can choose to ignore sensory inputs (like pain) so you don’t feel them

 

Julian Bowen

Julian is the Director and Principal Physiotherapist at EMC Physiotherapy.  He has spent  over a decade working exclusively in private physiotherapy practice, and estimates he would have performed over 40,000 individual treatments in that time. He has worked with everyone from Paralympians, elite athletes, WAFL Footballers, the Defence Forces and weekend warriors; to thousands of everyday people with all manner of issues.  He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries.

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How Pain Works Part 1. All pain comes from your Brain

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Over the last 5-10 years we have learned A LOT about pain and how it works, but a lot of this is completely foreign to most people, so we’ve decided to produce a series of articles to help people actually understand their pain and what is going on… Firstly because KNOWLEDGE IS POWER! And secondly because understanding why you feel how you feel is empowering and dethreatening (as they say – just knowing is half the battle)

This is part one of a 5-part series on learning how pain works!

ALL PAIN COMES FROM YOUR BRAIN

Now intuitively we all understand that pain comes from receptors in our body. We have nerve endings all over our body that pick-up pain signals and signal to our brain that we are in pain, right?

Sorry but that’s actually wrong!

All pain (and all sensory experience for that matter) comes from our brain. Our body is providing millions of sensory input signal to our brain at all times, but our brain computes everything and then works out what to experience.

Then the OUTPUT from our brain is what we experience.

This makes sense when we compare what we may know about our other senses.

Our ears don’t hear sound. There are receptors in our ears that are sensitive to vibration of air particles, and when it picks up vibration of air particles those receptors then turn that into electrical information that is transmitted to our brain. Our brain then interprets that electrical signal and works out what we are hearing. What we hear is an output of our brain computing the signals.

Now we don’t hear everything the same. If you’re doing something else you might not hear at all, even though the vibrations coming into the ear are the same. So just having the receptors stimulated doesn’t mean we actually hear. It’s what the brain chooses to do with the input it receives that determines what we actually experience.

The same as our eyes don’t see – our brain sees from the information provided by our eyes. Our eyes bring in light and focus it on the parts of the back of our eyes. Light hitting those parts of the eye then stimulates electrical signals to the brain. (If you’ve read into this before you know that the brain actually receives the information upside down). Your brain has to interpret this information to then give you an experience of what you are actually seeing. If you’ve ever seen an optical illusion, noticed a blind spot or realise you can’t actually see your nose (even though it’s always in your field of view) you can understand that your brain interpreting the information it has available to it is what allows us to see.

(I bet you all just looked at your nose right now)

The same happens with pain as an input. Your brain is provided input from all over your body and it decides what you feel based on its own priorities (which we’ll cover in the coming articles).

So because of this, we know that pain isn’t just fixed or static, and more pain doesn’t necessarily mean more damage. It also means you can have a lot of pain with very little damage at all (have you ever seen someone scared of needles scream in pain before the needle even touched them??)

Knowing that pain is an output of your brain means that we can understand how we experience pain, and then help us to control our experience of pain.

Coming up in part 2, we’ll learn about pain as a warning system, rather than pain being an indicator of damage.

 

Julian Bowen

Julian is the Director and Principal Physiotherapist at EMC Physiotherapy.  He has spent  over a decade working exclusively in private physiotherapy practice, and estimates he would have performed over 40,000 individual treatments in that time. He has worked with everyone from Paralympians, elite athletes, WAFL Footballers, the Defence Forces and weekend warriors; to thousands of everyday people with all manner of issues.  He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries.

More