Why do we get chronic pain?
The traditional view is that pain comes from injured tissues. And it is true to a huge extent - if we cut our finger, we get pain. If we break our arm, we get pain. Some of us are unlucky enough to get relentless pain from something doctors might diagnose as sciatica, for instance. So that seems a simple question to answer, doesn’t it?
Not quite though.
According to the most recent research into the field of pain, it is actually caused by our brain’s interpretation of many factors, including the injury itself if there is one, but also..
the past - for instance, past injury and health history
the present - other current stressors, and the general resilience of our system
the future - beliefs about our ability to recover, anticipation of future relevant events
In other words, the general state of our nervous system as influenced by life and our experience of it! And the brain takes account of it all.
Pain is directly influenced by our perception of how dangerous and important something is to our body.
To give you an example:
If I bash my knee, I might have some pain from immediate injured tissues, but if life is otherwise good, it would generally calm down soon enough
However if I am already super stressed because money is tight, my partner is threatening to leave, someone close to me is in hospital and not doing that great… my knee injury might well the the final straw for me and there will be a lot more pain
If I injure my knee whilst running away from a dog that is chasing me, I might not even feel the pain - as the brain has other priorities
If I injure my knee but I am a premier league football player and tomorrow is a match of my career, I might be in a lot more pain
Do you see the pattern?
We get pain as the body - our brain - sounds the alarm: something is not right. Danger. Malfunction. PAY ATTENTION TO ME. Sort it out. Our body alerts us to potential danger triggers all the time to keep us safe. We are thankful for that as it is part of our survival mechanism.
But if the injury is not that important in the context - then a quieter alarm will ring, or none at all.
Chronic pain is particularly interesting. Once the immediate injury to tissues has healed, the pain should stop - healing takes somewhere between 3 and 6 months to complete.
However, pain that lasts over 3 months is chronic and it does not reside in the body's tissues. Where does it come from?
It still remains, very much, a construct of the brain.
Oftentimes, the danger had passed, but the alarm keeps ringing. This is not just annoying and loud, but also wasteful and distracting. The brain had evaluated the environment and concluded that there is still danger associated with the experience of the injury around the site of it.
Actually - the brain had become TOO GOOD at ringing the alarm but not so good at turning it off.
But why?
The brain is trained to protect us and gets stuck in this super-protective mode. This alarm is now a mistaken signal caused by over-sensitivity to something that had been and gone. It is NOISE in our brain we can do without. Evolutionary, it is less important to turn off the protection mechanism than to sound it, just to keep us extra-safe.
Next time - read about how this happens, what our brain can be sensitive to, and, crucially, WHAT WE CAN DO about it.