When pain stops protecting us.

Pain protects us. When we touch a hot stove it is pain that causes us to pull our hand away.  For most people, most of the time, it’s a reliable communicator of the danger we are encountering.  In the case of injury – whether a sprained ankle or strained back – pain tells us when and where our tissues have been damaged, letting us rest the area or seek medical attention. The vast majority of our patients see us because they’ve felt pain in one way or another.

But pain can also be inaccurate, especially in the case of chronic pain; typically pain that lasts more than 3 months. While pain that lasts longer than 3 months can be due to ongoing tissue damage, much chronic pain has little structural cause at all, even if it started out as a “normal” injury.

How does acute pain turn into chronic pain?

When you suffer an injury, your nervous system alerts the brain that something isn’t quite right.  The brain reacts by responding with a sensation of pain. Something akin to a conversation; “Thanks lower back, I hear you. I’m going to make you hurt so you don’t move and hurt yourself any further”. During this time, your neural pathways become more sensitive to ensure you remain aware of the injury, and allow it time to heal.

However, sometimes this sensitivity in the neural pathway can remain even after the tissue has healed, especially if the injury has been ignored for too long or if its recovery was mismanaged.  Emotions such as fear and anxiety can heighten this neural sensitivity. It’s something we’ve seen during Covid.  Many patients have reported that their aches and pains have become more noticeable alongside the increased general anxiety that they’re suffering.

This over-sensitisation will often bring to light past pains or injuries, and cause patients to enter a cycle of despair.  Pain leads to fear which can heighten neural sensitivity, and lead to more pain.

Chronic pain can also spread and travel around due to “neural smudging”, where the oversensitivity of one part of the brain can spread to a neighbouring area that controls different parts of the body. But that’s another story…

Because we’re so used to pain working as intended, sufferers of persistent pain sometimes don’t understand why their pain remains. In normal times this often sees them search the merry-go-round of different opinions, only to end up in the hands of a quick fix ‘quack’.  But in times where medical access is restricted – think lockdown – they often turn to self-medicating with alcohol or drugs. Anything to reduce the pain.

So what to do?

1. Recognise that the mental and the physical aren’t separate. They interact and can influence each other. Intuitively we know it. When we are anxious we can feel our heart beating or hands shaking. Our mental anxiety is manifesting in an altered physical response. The same can happen with pain.
2. Get help. See somebody who takes the time to listen to your story in full, and helps you plan a path to recovery that takes into account your individual situation.
3. Understand that we are living in exceptional times. Our routines have been upended, and our stresses have been magnified. For many people, eating, drinking and sleeping habits have worsened. These things contribute to an environment conducive to persistent pain or injury.

So, if you’re suffering pain that won’t go away, or an injury that hasn’t recovered, be proactive. We’re now back at Somerset House and ready to help you.

Email info@coventgardenphysio.com or book online here.

Keep moving

Cameron Tudor

Clinical Director