Why am I in pain?

Pain is a normal experience. When you feel pain, it means that your brain believes your body is in a dangerous situation. Pain acts like your body’s alarm system, sending a message to be processed by the brain which then decides what action needs to be taken based on the actual or potential tissue damage being detected. While it can sound like a simple system, we now know that pain is a very complex phenomenon, and that the severity of pain that we feel does not always correspond to the degree of real tissue damage.

When we hurt ourselves, the tissues in the area activate a response known as inflammation, which helps with healing.  All tissues typically do heal, but the timeframe for that recovery can vary. Although we expect that as tissue heals, pain should also decrease over time, this is not always the case. There may be several reasons for ongoing or increasing long term pain, but one common component is the central nervous system (brain and spinal cord) becoming overly sensitized to pain. In this state, the brain is getting magnified danger messages from the body and therefore the amount of pain you feel does not always correspond to the amount of actual tissue damage that exists.

One of the most important strategies for managing pain is learning about your pain. Studies have shown that having a better understanding of persistent pain can actually decrease the threat perceived by the brain and ultimately calm down the sensitized central nervous system. Another helpful strategy is known as pacing and graded exposure. For many people, negative beliefs and fear can result in avoiding activities or movement and make their pain even worse. Working with your physiotherapist will help you to get back to your usual activities by employing a gradual approach to avoid flare ups of pain.  Of course, it’s also important to address any underlying physical issues which can be contributing to your pain; for example, muscle strength, joint mobility, and motor control.

There are many different approaches to dealing with persistent pain, but the most important starting point is a thorough assessment by a healthcare professional. They will be able to work with you to understand the reason for your ongoing pain and together make a plan to address the underlying issues.

For more information, check out this article by Cathy Rogers: Why-am-I-in-Pain

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