Decoding chronic pain: insights from Chiropractor, Ben Goodall

Understanding Chronic Pain

Chronic pain isn't just your run-of-the-mill ache or soreness. It's like having an unwelcome guest that sticks around for months on end. It’s generally defined as pain that persists beyond 3 months. Although this could be due to a repetitive injury or poor recovery, its more commonly associated with pain that persists well beyond normal healing times, pain that presents without any obvious injury, or pain that is more severe and widespread than you’d expect from the triggering event. It’s purpose as protection from further damage is no longer helpful, and rest is rarely the answer.

Chronic Pain Conditions

Chronic pain comes in many shapes and sizes. You've got conditions like fibromyalgia, where your whole body hurts and you suffer from fatigue and sensory sensitivities. Then there's complex regional pain syndrome, where even the slightest touch can send shockwaves of pain through the affected limb. However, chronic pain isn't exclusive to conditions with complex-sounding names; everyday ailments like arthritis, low back pain, and whiplash can also transition into chronic states.

The Science Behind Chronic Pain

Chronic pain isn't just about what's happening on the surface; it's about what's going on inside your body. You see, your body has this amazing warning system called nociception. It's like your body's way of saying, "Hey, watch out, there's danger ahead!" Think about it like stepping on a rusted nail. The nerve endings in your foot send an instant danger message to the brain which responds by producing pain. That immediate pain is your brain’s way of telling you to take action to protect yourself.

Normally, when you remove the nail and tend to your wound, your body's alarm system gradually calms down. But in chronic pain, it's like that alarm system gets stuck on high alert. Even when there's no real danger, your body keeps sending danger signals, making it feel like the alarm just won't stop ringing.

But that's not the only thing going on. You see, your brain is like a control centre, working 24/7 to block innocuous background pain messages from reaching your conscious mind. It's a process called descending inhibition, and it's what helps you go about your day without constantly being overwhelmed by unnecessary amounts of pain. But when you're dealing with chronic pain, those systems that block pain aren't working as well as they should. Meanwhile, the systems that enhance pain signals are working overtime, making the pain feel inappropriately more intense.

More than just pain

As if the persisting pain wasn’t enough, due the heightened alert state of the nervous system in chronic pain conditions, chronic pain is often associated with a host of other unpleasant symptoms. This may include increased sensitivity to light and/or sound and/or odours, sleep disturbance with frequent awakenings, fatigue, and cognitive problems such a difficulty to focus, attention deficits, memory disturbances, and many more.

Navigating Misconceptions

You've likely heard suggestions like "it's your posture" or "your hips are out of alignment" or “you need to strengthen up” regarding chronic pain. While well-meaning, these ideas lack strong evidence and can create confusion for those already struggling with persisting pain. Hopefully as you can now imagine, focusing solely on these factors oversimplifies someone’s experience and can lead to missing other important, bigger picture contributors to chronic pain, as well as instil fear to movement.

Tackling Chronic Pain

So, what can you do about chronic pain? The good news is, there are lots of options out there to help you find relief, and a good clinician should be able to help you explore these and put together a programme of care that tackles your pain from multiple directions. When it comes to calming down a ‘warning system’ that has become overprotective, we can use exercise, manual therapy, relaxation techniques, education, graded exposure, lifestyle advice (such as sleep hygiene tips and stress management), and more. The key is finding what works best for you and sticking with it. And remember, you're not alone on this journey. With the right support and understanding, you can start to reclaim the quality of life you deserve.