Understanding is the Key to Treating Chronic Pain
By Jonny Ebersole, PT, DPT, OCS, Cert. DN
Chronic pain affects millions of Americans every year and can be difficult for healthcare professionals to treat based on its complex nature. Costs associated with treating chronic pain in the United States are estimated at $635 billion dollars a year which is more than cancer, heart disease, and diabetes. A greater understanding of the mechanisms of pain and chronic pain can often be a first step to seeking appropriate treatment.
Pain is a protective mechanism in the human body designed to alert a person of an injury or danger. It is an experience that every person will encounter at some point in his or her life. Pain can be separated into two basic categories: acute pain and chronic pain. Acute pain is often caused by a musculoskeletal injury and lasts anywhere from one day to three months. An example of acute pain is putting your hand on a hot stovetop. Your body reacts to the injury and danger by alerting you to remove your hand from that stovetop to prevent further injury. As the burn on the hand heals the pain normally goes away. Chronic pain is defined as pain that lasts longer than three months and is more complex than acute pain. Chronic pain is more than simple muscle or tissue damage and often involves changes in the brain and nervous system.
Scientists continue to learn more about chronic pain and the central sensitization changes that occur in the brain and nervous system. To understand central sensitization, it is helpful to understand the basic mechanism of how pain works in the body. First, tissue damage sensing nerve cells send a signal to the spinal cord which sends that signal up to the brain. The brain receives and interprets that signal and decides what to do with it. It then sends a signal back down the spinal cord and nerves with how to respond to that pain. The brain also decides how to respond to pain by sending a signal back down the spinal cord and body telling the body to decrease or increase the pain signal.
With central sensitization, the nervous system, spinal cord and brain get so used to receiving pain signals that they increase the resting rate of activity. With chronic pain, non-painful signals sent to the brain may be interpreted as pain and danger by a hyperactive nervous system. Now, if you stub your toe, your brain may interpret that as a “10 out of 10” pain when previously it would have been “4 out of 10.” Even performing 15 minutes of walking might get interpreted by a hyperactive nervous system as painful and dangerous. Another change that happens is the brain and spinal cord cells send pain signals without any painful stimulus. For instance, a back injury or tissue damage that first caused pain has healed; however, the chronic back pain that person is feeling is a fake signal sent from nerves in the brain or spinal cord.
Treatment options for chronic pain also continue to advance as chronic pain is better understood. If you find yourself dealing with chronic pain, it may be helpful to consult your doctor for appropriate treatment. A medical psychologist may start with pain education and coping strategies. Studies have found that patients who understand the mechanisms of pain and how it affects their lives tend to have less pain and improved function. Physical therapy, including a relatively new modality called dry needling, can be helpful for improving the body’s tolerance for activity and the nervous system’s perception of pain.
No one should endure chronic pain. At Sheltering Arms, our physicians are dedicated to using the least invasive methods for easing your pain as thoroughly and efficiently as possible. Let them help you today. Call (804) 764-1000 to schedule your assessment.