Why We Feel Pain, And What Can We Do To Reduce It

A couple of months ago, I wrote about causes of chronic pain.

I explained how the “pain equals tissue damage” is a very outdated way of looking at pain - this is more relevant for new acute pain, and sometimes not even that.

Pain always has lots to do with your thoughts and emotions. It is about story telling especially with chronic pain when any tissue damage had long since healed.

The way we perceive pain has tons to do with perception of danger in our brain. High risk, much protection needed - we tend to get a lot of pain. Low risk - not much pain, or none, even. So things like major nerve impingement would give us a lot of pain, as that is super important for the brain.

But disc herniation in the spine can go either way - if the brain thinks a major disc bulge is something the body can cope with, we won’t feel any sensations. Importantly, the level of inflammation plays a key role. An acutely inflamed area around a disc herniation is correlated with more pain in the area.

Makes sense, right? It is interesting to see how that actually works in detail.

So let’s have a look at the inflammation aspect.

We have various nerve fibres carrying information to the brain. A-nerve fibres are like the fast, large “motorway” path nerves that pick up quick signals, with a special myelin sheath coating to protect the information and speed it up.

A-alpha nerve fibers carry information related to proprioception - the body's sense of its own position, movement, and location in space.

A-beta and A-delta nerve fibers carry information related to pain, pressure and temperature where it is needed Like - oh no, I just burned myself! They also respond to inflammation signals.

On the other hand, C-nerve fibers carry information related to dull, aching pain, gentle touch, temperature and itch, but also inflammation. The sensations we feel after the shock of the initial scald had worn off.

C-nerve fibres are slower in terms of information transmission, whilst carrying a huge amount of important signals about things not going right for the body.

If we have lots of stress hormones - let’s say, I'm constantly worried about my kids at school or I am at risk of losing my job and I am the only breadwinner in the family - we have lots of adrenaline and cortisol in the system. This is going to sensitise the C-nerve fibers and they will work differently.

If the body suffers from inflammation - infection, nerve compression leading to inflammation, or another chronic inflammatory response like poor digestion or an allergic response increasing histamine - we have lots of immune cells pumping out chemicals, which is also going to sensitise the C-fibers.

Inflammation is actually a protector - it's an attempt to respond to perception of danger and defend the body from a problem. But it can also cause pain as an output.

A sedentary lifestyle that chronically deprives the tissues of oxygen will also alert these C-fibres since oxygen deprivation is a source of great concern to the brain.

This is bio-plasticity in action - our immune cells are talking to our C-fibers along the whole length of the nerve. It's changing how every nerve fires with beautiful complexity and great sensitivity.

These nerves are actually are tiny, and harder to see on a microscope, so scientists didn't pay that much attention to them until fairly recently. But it turned out that these little fibres are super essential to signalling danger in the body.

An interesting fact is that for every one quick signal with A-nerve fibres, there are probably around seven or eight slow signals with the C-fibres. Those C-fibres are the little country lanes that keep massive amounts of essential local traffic circulating whilst the big lorries are speeding down the motorways of the A-fibre signalling pathways.

And these busy C-nerve fibres are very, very tightly correlated with pain.

So to address our pain response, we need to look wider than we might have contemplated before. We need to look at sources of inflammation, our immune system, our overall mobility - are we too sedentary?, as well as our overall stress levels, hormone imbalances, and potential tissue compression areas.

As always, it is a holistic approach. Movement and the mind-body connection as part of reducing stress levels definitely plays a key role. I would also strongly support you to make healthy dietary changes - an anti-inflammatory diet is essential, for instance, for arthritis, but as a preventative measure, too. Do also check your hormone levels, and deal with any long standing compession issues in the body, such as nerve impingment or spinal disc issues.

For many of the latter things, Pilates, rehabilitative movement such as Restore Your Core, and work with nerve re-compression (all the things that I do as part of my work) are great. Happy to chat about this further!

To your health, Kaye