Everything you need to know to tame your pain – Part 3

A short recap of all you need to know to tame your pain so far…

I’ve worked as an osteopath and a university neurosciences lecture for the better part of 2 decades. In that time our understanding of pain has changed enormously. Everything we thought we knew about pain has been tipped on its head. This has meant that myself and my colleagues have had to work hard, to keep our practice teams and the profession moving with the science on pain.

As a lecturer I spend a lot of time banging on about the value of pain education, because getting the best possible outcomes for our patients means that therapists and patients need to be on the same page. We need to share the same understanding of the problem and the same goals for treatment. We need to work as a team, always pulling in the same direction.

To that end, this series is really to help patients understand the science. So that they can be empowered to create positive change in their life. It is literally the most important things I want them to know, to help them pave the way to recovery.

neck pain
sick woman with headache.

The recap

From part 1

  1. Knowledge is power so if you haven’t done so yet, get back to the first blog and follow the links in the resource section. There is some real gold in there. Get schooled and get in control of your recovery.
  2. Pain does not equal tissue damage, and more pain does not equal more damage. That does not mean that the pain without tissue damage is not real, and it definitely does not mean the pain is in your head. It just means that the pain itself is the problem, the pain is the pathology that needs treating. We need to treat the pain, not the part of the body you feel the pain in. There is a subtle but critical difference there.
  3. Pain is protective and when we work with our nervous system to decrease the perceived threat it’s responding to, pain will typically subside. When it doesn’t, we have chronic pain and chronic pain is different to acute pain. It is a totally different beast.

From part 2

  1. Chronic pain is different to acute pain. It persists well beyond the time taken for tissues to heal and results more so from nervous system changes than from poor healing. These changes essentially make the nervous system much more sensitive, meaning it produces more pain and inflammation with less or sometimes even no provocation at all.
  2. Multiple pain sites and recurrent episodes of familiar pain are still chronic pain. These types of pain typically occur not because an old injury has failed to heal but because our normal protective responses have hung around long after the injury healed.
  3. Pain will create musculoskeletal findings because the nervous system controls our muscles, joints, and movement. As such the nervous system changes that cause pain often also cause changes to our muscles and joint etc. These musculoskeletal findings reflect the state of the nervous system. They are not the cause of the pain we experience. They are symptoms of nervous system dysfunction.

Chronic pain does not have to be constant.

Chronic pain does not have to be severe.

 It does not have to be debilitating.

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The aim is to identify it and to treat it before it becomes any of those things!

Pain is not caused by “poor posture”, weak muscles or being “out of alignment”

7.  This ties in with the last point that pain causes musculoskeletal findings and if you’ve grasped that concept well, this should be a natural follow on.

Essentially posture and positional changes, weakness, stiffness etc. are all part of the musculoskeletal symptoms generated by altered nervous system function. More than likely these changes are part of a package of protective functions that are activated when we’re under threat. They largely serve recuperative or defensive functions to ensure recovery, safety and/or a fast getaway but when they hang about for too long, they become more of a hindrance than a help.

We so often see these changes with pain because the underlying nervous system changes mean they tend to occur simultaneously. But, as we like to say, correlation is not causation.

That then begs the question “is there any use in getting manual therapy for these symptoms”? The answer is of course – that depends…

Pain is not the result of weakness, bad posture or misalignment of joints.

6.  Lastly for today – Pain will create musculoskeletal findings such as tension, tenderness, stiffness, and weakness. The presence of these findings does not mean that these structures or phenomena are causing your pain.

Remember that chronic pain is the result of changes in nervous system structure and/or function. The nerves and neurological structures that send signals to your muscles and joints to create tension and movement are those whose function is altered.  Same goes for those that send signals about the sensation of muscle tension and joint stiffness.

These musculoskeletal findings, like your pain, are very real. They are just not the root cause of your problem – they are a symptom. An output of a dysfunctional nervous system. Treating them can bring relief and can be a useful strategy in the short term (we LOVE manual therapy!) but manual therapy alone will not ‘fix’ your problem.

To learn more about your pain and the best ways to tackle it, stay tuned to our blog for the next part in the series. If you’re struggling with pain and need help to tame the beast, come visit us at 632 Queensberry street North Melbourne, call us on 03 83703044 or book online now. We’re here to help!

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