Have you ever wandered why after a bad nights’ sleep, you are in an irritated mood or feel more pain? As sports physios working with teams, why is it that when a team wins their game, players have less injuries and complaints versus when the team looses, players have more injuries?

It used to be believed that when you injured a tissue, a message would travel up to your brain to say the tissue was damaged. The brain would register that information and then signals would be sent back to the tissue saying the area was in pain. But this didn’t explain phantom limb pain. So if someone had an amputated leg, how was it possible they could still feel pain or an itch in the leg that is no longer there?

Scientists and medical professionals have shown that the brain is the powerhouse for understanding your perception of pain and that pain is in fact related to many factors. It isn’t just to do with the amount of tissue damage you may have experienced. Instead, your perception of pain is to do with a huge range of factors. This includes:

• Sleep – the more pain you have, the poorer your sleep pattern. Poorer quality sleep also makes you feel more pain.

• Immune system – when you experience ongoing pain, this can weaken your immune system, making you more susceptible to things such as colds. When your immune system is down, you generally feel more achey.

• Your mood, stress and your environment– the more stress, anxiety and worry you have about anything in your life, the more pain you will have. The more pain you have the more you are going to feel stressed and anxious.

  • For example, your pain may be worse if a relative has just died or you are moving house or you have work pressures.

• Past experience and your thoughts can dictate your brain’s perception of pain. For example, if you have recurrent episodes of acute low back pain, you may experience either:

  • more pain because you know what is involved to get you better, you may become emotional, frustrated and fear the pain you have had in the past. All these factors can escalate the amount of pain you are experiencing.

  • less pain because you have had a good understanding of your pain in the past and you know what to expect.

    

Chronic pain is a huge problem in Australia, where 1 in 5 people have it. The brain keeps producing pain even though the tissues are restored and out of danger and any other serious diagnosis have been ruled out.

Note the difference between acute and chronic pain.

• Acute pain is defined as pain you may experience for less than 3 months. For example, if you sprain your ankle and you make a speedy recovery.

• Chronic pain is pain that lasts for longer than 3 months and where the ongoing pain is to do less with the structural changes to your body and more to do with sensitivity of the nervous system. That is, the tissue damage is not the main issue.

What should you do about it?

We need to retrain the brain and nervous system. The brain is not fixed. It is PLASTIC. You may have heard the term before, neuroplasticity – where we can retrain your brain (for an interesting read, see Norman Doidge’s book The Brain That Changes Itself). These are the factors to work on:

• Medical

  • Medication can help to get you going but should be tapered off and ceased as your symptoms settle.

  • Always get a second opinion, especially if you are told to get surgery and you have any doubts.

• Keep your approach active

  • Learn ways to decrease your stress levels and wind down the nervous system. This can help with your emotional wellbeing and can reduce pain.

• Diet and lifestyle

  • Our sedentary lifestyle and what we eat contributes to a sensitized nervous system. Take a good look at your diet and lifestyle and make appropriate changes to your drinking and smoking habits, diet and exercise.

• Explore the deeper meaning of your pain by looking at what was going on in your life around the time the pain developed. Any worrying periods of life can make pain worse so think deeply to recognize your emotions.

• Physical activity

  • Get moving at comfortable levels without fear. Slowly build back your normal activity levels.

If you want to learn more on this topic:

• see the following youtube clip https://www.youtube.com/watch?v=4b8oB757DKc

• read the book by David Butler, Explain Pain. (This can be found at http://www.noigroup.com/en/Product/EPBII)

Pain comes from the brain. The brain can be re-trained. But to re-train the brain, you need to look at a broad perspective and all the factors contributing to your pain.