Manage Pain Efficiently with 3 Simple Methods
Do I have to live with pain? I have had pain for years, so how do I get rid of this chronic pain? Is pain real or is my head just messed up? If you have ever thought about these questions, you are not alone. Pain has been a topic of research for decades. Over the years, we have developed methods to treat ailments, injuries and diseases. Only in recent times, we’ve started to scratch the surface of what pain is, and how to manage pain.
Pain is real and not just a figment of your imagination. It is multifactorial and complex. If we understand it better we can learn to manage it, be in control, and eventually, learn to overcome it. This article aims to shed some light on what pain is, and some tools we can use to help us better deal with it.
What is pain?
“Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”
Although pain is real, pain and actual tissue damage are actually 2 separate things. Pain essentially is a response to a perceived threat, regardless of whether there is actual tissue damage or not. For example, if you have been burnt by a hot kettle before, your body remembers that unpleasant experience and when you next see a kettle with steam coming out, indicating hot water/boiling water, that memory can cause pain although there is no actual damage to your skin. We are then more careful with handling the hot kettle to prevent scalding or hurt to our skin. This tells us that pain is actually important and relevant as it serves its purpose of protecting us from harm.
When pain occurs over an extended period of time, our body gets more sensitised to a variety of stimuli and amplifies the sensation of pain. This creates a state where intense pain can be elicited with even the most mundane of triggers. For example, imagine having injured your back previously while bending forward to pick up something heavy. Even after your back is recovered, your body may still react with pain whenever you bend forward. Prolonged periods of pain can also disturb the central systems in the body, causing increased sensitivity to aches and pains in other areas of the body as well.
How does pain develop?
To understand why pain is present during certain movements or behaviors, we must first understand how a movement or behaviour is developed. When we learn a new skill, or engage in a certain task or movement, a pathway is developed in the brain to allow a signal to be sent down to the rest of the body. Picture this pathway as a causeway or a bridge, and the signal as cars. When a stimulus is triggered, a causeway is formed, and cars start to travel across this causeway to reach its destination. If the intensity of the stimulus increases, through duration, frequency or mass, so will the amount of cars that travel across this causeway.
The body registers this increase in traffic flow and starts to build new lanes along this causeway, allowing the vehicles to reach their destination faster and smoother. This is why shooting a basketball gets easier as we practice; pianists are able to play complicated pieces effortlessly; and why we instantly register that 1+1=2. However, due to a myriad of factors, instead of having a smooth journey across the causeway, the journey now becomes tedious and unpleasant. This is then represented as pain when we are trying to execute a specific action or task. In the section below, we will be discussing some of the factors that negatively influence said journey across the causeway.
Doing more than our body can currently handle. For example, if you suddenly embarked on a 5km run after being sedentary for years. This sudden increase is represented by a sudden increase in cars that are travelling down the causeway. When the traffic flow exceeds the speed at which new lanes are built, congestion forms along the causeway. As the body cannot cope with the increased traffic flow, it starts to recognise it as a threat to the system. Hence eliciting pain in an effort to curb that traffic flow.
When we get injured doing a specific task, lanes in our causeway crack and crumble, making them inaccessible. As such, barricades are being placed around these damaged lanes to stop cars from entering, causing congestion to the other available lanes. These barricades are important to allow time for the damaged lanes to be repaired. In the case of chronic pain post-injury, these lanes are actually repaired, but the barricades are not removed. This causes the causeway to stay congested long after an injury heals.
What happens with fear is that all the cars along the causeway start driving very slowly, possibly way below the recommended speed limit. This will also create congestion along the causeway, driving that unpleasant experience. As for avoidance beliefs, picture cars literally u-turning at the causeway junction just to avoid entering the causeway, and how much of a chaos it would cause.
Stress, previous experiences, emotional vulnerability
Have you ever noticed that your pain increases when you are stressed, or when your workload increases? Part of it may be due to the increase in physical demands, but part of it may also be due to the compromised mental or emotional state that you are in. Although mental or emotional factors do not directly interfere with the actual signal along the pathways, it actually presents more like a protest rally that happens around the causeway. Imagine crowds of people standing on the streets holding a rally. These people have no intention of crossing the causeway but are taking up space for the actual signals to travel through the causeway. Cars would then have to either navigate through the crowds of people, or it could result in a bottleneck situation, creating congestion.
When our body starts to associate these movements and tasks as a negative or threatening experience, it triggers pain as a response to inhibit us from engaging in these tasks.
So how do we manage pain?
The concept of managing pain revolves around our ability to change these ‘threatening’ negative experiences into ‘safe’ positive ones. Increasing our body’s capacity and tolerance toward provocative activities can also help manage pain. An improvement would be doing more without an increase in pain, or that your body recovers faster. Not all the factors need to be resolved for you to feel pain-free. We can work on a couple of these factors and be better equipped to manage pain.
Manage Pain with Exercise
Exercise does not mean getting you to run 5km every day. Everyone’s definition of exercise differs but one simple definition is an activity that increases heart rate over a sustained period of time. This can be as simple as going for a walk in a park, doing repetitions of a sit to stand at your desk, or even doing a simple routine of stretching exercises. What exercise does for pain is that it offers alternative destinations for the cars to travel to, reducing the amount of cars that are trying to cross the particular painful causeway.
Manage Pain with Graded exposure
The body responds to the increase in stimulus by building more lanes along the causeway. Too little stimulus and the body has no incentive to create more lanes, too much stimulus and congestion will happen. Finding the right amount of stimulus where the rate of which lanes are built keeps up with the amount of cars travelling down the causeway allows us to gradually increase our activities and function without triggering painful responses.
2 simple rules on how to grade back to an activity or movement safely:
- Stay within a discomfort level of between 1-3/10
- Have enough rest time in between where you do not start an activity when already in pain.
If you have pain walking, you can walk till you feel a 1-3 discomfort level. What you should start to notice is that the duration or distance that you are able to walk gradually increases.
Manage Pain by Creating a ‘safe’ environment
Being stuck in a traffic jam can be an unpleasant experience. But it can be made better if we were to be listening to our favourite music in the car; being surrounded by friends or family; having enough time and not rushing; driving along a familiar road. Creating a ‘safe’ environment while executing a painful movement can reduce the threat, hence reducing the pain response. If walking in a park was a painful experience, try walking with friends or while listening to your favourite music. You will likely notice a difference in how the body feels during the walk.
Seek Help to Manage Pain Effectively
Pain is multifactorial and more often than not, there is no one surefire method to get rid of the pain. However, with an increased understanding along with tips on how to manage pain, you will gradually see an improvement. If you are experiencing chronic pain that is affecting your daily life – make an appointment to speak to a physiotherapist. We are able to help you resolve your musculoskeletal pain so that you can experience life fully.