Chronic Pain Part 1- A negative belief system?

Are you a long term pain sufferer? Tried and failed with many treatment options? Unclear diagnosis? No explanation or cause for symptoms? You simply want answers!? This article is the first in a two-part series providing you with important knowledge of the factors that contribute to the development of chronic pain……..

General Facts

What a lot of people do not know, is chronic pain is often the result of an individual’s own perception and ability to deal with pain, and they are heavily influenced by culture, surrounding healthcare practitioners and or peers. For this reason, it is important to ensure that information provided to pain sufferers, is both accurate and not detrimental to recovery so that a person does not go on to form negative belief systems which can lead to the development of chronic pain.

Acute Vs Chronic

In the acute stage of injury, the sensation of pain acts as a warning to protect us from actual, potential or further tissue damage. Pain will cause a person to modify their behaviour, to prevent damage, providing the affected area time to rest for healing. However, in some instances, pain can exceed the length of time expected for an injury and thus becoming chronic.

Chronic pain differs from acute pain as it does not function as a warning signal to prevent tissue damage, but occurs as a result of malfunctioning of the nervous system.

Types of back pain

Chronic back pain sufferers can be categorized into two groups. The first group (15%) an organic cause for back pain can be identified with x-rays, MRI scans, blood examinations, or other medical tests. A few examples of organic causes of back pain are:

  • Sipped disc
  • Multiple sclerosis
  • Ankylosing spondylitis
  • Spinal tumours

For the remaining 85% of the chronic back pain population, there is no specific or identifiable cause for the person’s experienced pain. In such instances, the source of pain may stem from a wide range of factors such as a previously unresolved tissue injury, fear-avoidance, poor postures or a sedentary lifestyle of no exercise. A single or combination of these factors could contribute to a mild acute pain developing into severe chronic pain.

Whatever the reason, the source of the pain may be difficult to identify and is often misunderstood and therefore misdiagnosed and mistreated.

Negative Belief systems

Although genetics is recognised to be a contributing factor, it would seem that a person’s lifestyle and psychological state/belief, has the greatest influence on an individual’s pain experience.

Scientific research has shown that stress, anxiety, depression, and negative beliefs systems regarding pain can prolong a person’s disability. Over time, psychological tension can have a physical effect on the body, causing damage to the muscles, joints, skin, and neural tissue. This can exacerbate the person’s pain experience making it greater than previous, creating a vicious cycle of pain.

Unfortunately unintentionally, many health care practitioners may play a role in contributing to an individual’s negative belief system. Incorrect advice or unclear explanations to pain sufferers, could encourage movement avoidance, pain behaviours and facilitate poor coping strategies. Common examples of this are advising long periods of bed rest and advice to avoid certain movements, following an acute episode of back pain. Such instructions could be the driving force in the development of acute pain into chronic pain.

When somebody resumes bed rest for long periods of time, the muscle fibres adapt quickly to their new position and start to lose length and strength. After a while the muscle becomes stiff, restricting the normal movement of the joint. This will lead to further irritation and stiffness of the spinal joints and eventually, the release of more pain chemicals. As the person begins to move, the pain sensation will be greater than previous. This will reinforce the distorted belief that the body has not had enough time to rest and that movement is harmful and thus painful.

In the long term, a person will develop gross stiffness and intense fear or movement which has been reinforced by pain. Such people will struggle to execute simple daily tasks and this ongoing pain can lead to a varying degree of disability and can make a person feel very low in mood making it even more difficult to break this negative pain cycle.

Stay tuned for the second part of this article which discusses the treatment options for chronic pain sufferers.

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