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Chronic Pain

Pain is a complex matter. Most of us have suffered from it during our lives. But what exactly does our body tell us when we feel it? 

We now understand that pain does not necessarily equal tissue damage or explain the degree thereof. For instance, people with large disk prolapses can be completely asymptomatic, and conversely, those with minor disk protrusions can experience much discomfort. All the bodily events taking place are processed and interpreted by the brain, and if the latter believes that pain is useful in some way to the individual - e.g. as a warning mechanism - then that's what the person will feel. So it's an output from the brain, not a direct input from the body. 

Furthermore, the sensations can be exacerbated by other events not connected to the immediate physical danger or harm. Stress, anxiety, depression and similar factors will cause us to feel pain more acutely. Also, the longer pain goes on for, the more likely the person is to feel it even more acutely. They could start having heightened awareness of all body sensations - global sensitisation - or start fearing movement. 

In 1980'ies, scientists developed the fear-avoidance model of chronic pain, which explains how cognitive and behavioural factors explain transition from acute to chronic discomfort. This model shows that fear of pain is a major force in making the sensations chronic. It also brings with itself fear of movement, fear of re-injury, and is correlated with depression and anxiety. 

Alongside other methods of management of chronic pain like those suggested through pain specialists, mindfulness, and perhaps medication, Pilates can also contribute towards management of pain symptoms by working on the person's breathing, which calms down their nervous system, and through increased self-awareness with focussed and gentle movement and building stability in their body.


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