2021 - the year to free your chronic pain

There are two truths about pain. #1: your pain is real.  And #2: your pain is an interpretation that your brain makes about your situation and safety.  Hmm…

The International Association for the Study of Pain organization defines pain as: 

"An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage" 1. 

Acute Pain

To explain pain, here’s an example of how you can feel pain after an acute injury (when you first get injured): 

Let's say you're crossing a traffic-filled NYC street, cars waiting to jump ahead as soon as the light turns green, and suddenly you twist your ankle in the middle of crossing (thanks, potholes!).  Either you feel immediate pain, fall, and need assistance to continue the intersection, or you can miraculously run on the newly torn ankle to the safety of the sidewalk without feeling pain. 

How are these two entirely different reactions that follow the same kind of ankle tear even possible?  

If, during the injury, your brain also received information that a yellow cab was gunning towards you, the decision (made in milliseconds) to get you safely across the street was more important than protecting your torn ankle.  

Your brain didn't send pain because being stuck on the street was more dangerous than running on an injured ankle.  Only when you reach the sidewalk do you feel sharp shooting ankle pain, and lift your foot off the ground to protect from further injury.   

So, during an acute injury the brain chooses how best to respond to the most pressing danger by sending pain or no pain.

Persistent Pain

For many people living with persistent pain, the story continues.  Your ankle sprain heals, and you barely feel it until you come to that same intersection.  You remember the scenerio and as you start to cross the street, you suddenly feel pain in your ankle. This may progress to feeling pain anytime you approach any New York City curb.  You might be in Boston and realize that your ankle “is acting up” while crossing those streets too. 

We used to believe that we had nerves specifically for "pain," which would tell us about physical, body tissue injuries only, such as an ankle sprain.  But if that were the case, the pain of an ankle sprain wouldn't be changeable whether noticing the yellow cab coming at us when sustaining the ankle twist, or months later while walking across a different street.  

Today we know that our complex, protective brain compiles tons of information from our nervous system, immune system, current environment, memories, and past experiences.  

In a blink of an eye, the brain assesses everything that's happening, and decides how much pain chemicals to send. 

On the flip side, the brain can send feel-good substances like dopamine, endorphins and oxytocin.

Emotions and Pain

Remember, the definition of pain includes your emotions.  Awareness of feeling stressed, having negative thoughts, or feeling scared can be another first step in rewiring your brain and changing your pain. This is fantastic news!  It means there are many steps you are in control of to change your nervous system and help your brain feel safer.  The end result is less pain.

Like training for a marathon, strengthening the more healthy neural connections, changing your brain's reactions, feeling less pain, and having more feel-good sensations takes education, awareness, and practice.  

Awareness of your thoughts, habits, and reactions regarding pain can significantly impact the pain you experience.  

Start a journal, take a few quiet breathing breaks during your day, and the practice of a daily body scan can help you tune into your awareness.  Once you have an understanding of your reactions and thoughts, you can then start rewiring them.  Perhaps this means taking a breath before reacting, which gives your brain a moment to feel less stressed.

Maybe it means choosing more positive responses to situations that typically stress you out.  Or think of one or two things or experiences that you are grateful for. These positive practices will slowly help your brain recognize that a street in Boston is not the same as that pothole in New York, and your ankle's feeling of pain will permanently fade away. 

Healing Chronic Pelvic Pain

For women experiencing chronic pelvic pain, the eBook, Heal Your Pelvic Pain with Science written by Evelyn Hecht, PT, Master Clinician of pelvic physical therapy, helps you start your healing journey by learning more about pain science as it relates to the pelvis. To get your free copy, go to www.pelvicsense.com.  

While healing longstanding pain or pelvic floor dysfunction isn't an easy or quick thing to do, most worthwhile things aren't fast or straightforward. They take practice and patience. Most important, this is do-able as we at EMH Physical Therapy have been guiding many out of pelvic dysfunction for over 20 years.

What better time to start something valuable than in a brand new year of 2021? 

1.https://www.iasp-pain.org/PublicationsNews/NewsDetail.aspx?ItemNumber=10475

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