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.
Chronic pain is often the result of an individual’s own perception and ability to deal with pain. They are heavily influenced by culture, surrounding healthcare practitioners and/or peers. Thus, it is important to ensure that information provided to pain sufferers, is both accurate and not detrimental to recovery. This is so that a person does not go on to form negative belief systems that can lead to the development of chronic pain.
Acute Pain Vs Chronic Pain
The sensation of pain acts as a warning to protect us from actual, potential or further tissue damage in the acute stage of injury. Pain will cause a person to modify their behaviour to prevent damage. This provides 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. However, it occurs as a result of malfunctioning of the nervous system.
Types Of Chronic Back Pain
We can categorise chronic back pain sufferers into two groups. An organic cause for back pain for the first group (15%) can be identified with x-rays, MRI scans, blood examinations, or other medical tests can be used to identify back pain. A few examples of organic causes of back pain are:
- Slipped disc
- Multiple sclerosis
- Ankylosing spondylitis
- Spinal tumours
There is no specific or identifiable cause for the person’s experienced pain for the remaining 85% of the chronic back pain population. 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
Genetics is recognised to be a contributing factor. However, 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, many health care practitioners may unintentionally 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. This ongoing pain can lead to a varying degree of disability, and can make a person feel moody. This makes it even harder to break this negative pain cycle.
Stay tuned for the second part of this article which discusses the treatment options for chronic pain sufferers.