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Understanding Pain: Chronic Pain

In our Understand Pain: Acute Pain blog, we explored how we feel pain and what influences it. This pain is known as acute pain and occurs when we are initially injured. So what does it mean when you are told you are suffering from chronic pain?

Chronic and persistent pain is extremely misunderstood as it defies tissue healing times. Generally, most injuries in our tissues heal in approximately six to eight weeks. So when our injury heals we would be expecting our pain to stop because there is no need for our body to protect us any more. Then why do people suffer with lifelong pain and why does it persists past these healing time frames? Shouldn’t we stop feeling pain if our tissues are completely healed? I’m sure you’ve heard from people that they’ve been told that your pain is in your ‘head.’ And I’m sure many of you may have just been prescribed pain killers or have had extensive X-Rays and MRIs just to find out you don't have any obvious injury! This can be very confusing and can make people feel helpless as they don’t understand why this is occurring or how best to fix the issue.

Chronic pain is quite a complex concept and can be difficult to explain. Firstly, whilst the comment that pain is in your ‘head,’ is partly true, several factors can influence your pain. One factor in particular, is that negative thoughts can magnify your pain experience, but it is not the only factor that contributes to chronic and persistent pain. Essentially, our 'pain system' works in the opposite way to what we want. As explained previously, the nerves in our body recognise that something is occurring in our tissues, we feel pain, and then we make a change. However, with chronic and persistent pain, even when the tissues have healed, our body will keep signalling that we are in danger! Here, our pain system begins to work in the opposite to what we want and everything becomes super sensitised. The nerves in the area we had the injury are easily activated and become over protective. This means that our pain response is still triggered long past when everything has healed. These nerves can become triggered simply by performing day to day movements like sitting down for a long period of time or even by doing exercise that is beneficial. Over time, this response can be continually magnified to the point even thoughts of these aggravating activities can trigger a pain response.

Whilst this might sound like it’s all doom and gloom, pain scientists have made terrific discoveries over the last 20 years and have been finding ways to help reduce the impact that chronic pain has on individuals. Techniques such as steadily exposing the body to its pain response over time, in an attempt to reduce its sensitivity, has found to be beneficial. Other aspects such as examining an individual's mental thoughts towards their pain has also had a significant affect. But in some instances, the best form of treatment has been simple education surrounding how pain works; how we feel it; and how it can become chronic.

What makes chronic pain so difficult to treat is that everyone’s pain experience is extremely different. Not one person will have the same response to the same injury. Some people will experience more pain, while others might have no pain. Additionally, certain treatments will work better for some than others.

In a nutshell, this is why pain is so complicated! And this is why it can be so poorly treated, as there can be so many ways to treat chronic pain as not everyone is the same.

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