Why Does Pain Persist?
A few years back I broke my leg. It sure did hurt when it happened.
Over time, as it healed, the pain ebbed away.
After a few months, I went through physical therapy. Within a handful of sessions I was basically back to normal - able to walk, run and jump.
Nowadays if you look closely the healed broken leg is a bit thicker than the uninjured side.
However, if you ask me how it affects my life, I’ll tell you it doesn’t.
The pain went away when the danger of the injury was gone.
That’s what’s supposed to happen, and that’s how it goes for most people.
However, for people with persistent pain, the story goes differently.
Research indicates that the difference is written in the nervous system.*
Instead of recognizing that the injury has healed at the tissue level, the brain continues to fabricate a sensation of pain.
The affected body part continues to ache, throb, burn, feel weak, feel tight, resist, get stuck and so on.
Now, as a mental exercise, think of all the people who’ve lost limbs but go on to compete in the paralympics.
Next, think of people who have objectively less traumatic injuries, but become disabled by intense daily pain.
Of course, some people have underlying conditions that make them more likely to suffer from chronic pain. However, many people don’t and are left wondering,
“Why is this happening to me?”
Why this happens to some people and not others isn’t fully understood.
This is exactly why treating and resolving persistent pain is so complex and complicated.
When pain is new and related to a fresh injury, the first thing a doctor will do is prescribe anti-inflammatory drugs like Ibuprofen.
They might prescribe muscle relaxers, or opioid pain relievers.
They’ll tell you to rest and avoid re-injury.
That doesn’t mean lay in bed all day. Movement is still vital.
Physical therapy often starts at this point.
This regimen continues for about three months, by which time most people feel a lot better and the end of pain is in sight.
For a minority of folks however, something goes haywire in the brain. *
Instead of pain acting like a warning against further injury, it’s like an alarm that won’t shut off.
Doctors may order an MRI to see if there is unresolved damage at the site where it hurts.
When images look normal some people feel relieved, and the pain dissipates on its own.*
For these people, we suspect that psychological factors such as worry and fear of getting hurt played a role in their persistent pain.*
When images show significant or unresolved tissue damage, doctors may discuss surgical options.
Though it should be noted that no one can cut away pain.
Recent studies even suggest that orthopedic surgery is no more effective than "fake" surgery at resolving conditions such as chronic knee and low back pain.*
In fact, it's common for people to have tissue damage that can be seen on MRI's, but not have pain.*
Other studies* show that meditation and mindfulness practices can be used by people with persistent pain to reduce the intensity of pain.
Persistent pain and depression are also understood to be linked in the brain.
People in pain may suffer from social isolation and become depressed* as a result of their conditions.
At the same time, it is thought that when people with chronic pain have strong family ties and healthy social lives, they feel better.*
Interestingly, one of the benefits of massage and physical therapy could be the contact and friendly interaction between the patient and the therapist. *
Studies across healthcare suggest that an important factor in recovery is how much a person likes and trusts their therapist.*
Over and over again, researchers are discovering that our beliefs about our bodies, how we feel about our experiences, our social supports, and even our relationships with our healthcare providers are extremely important in managing persistent pain.
We know from a vast body of research that the old stories about massage therapy being used to break up knots, stretch tight muscles and flush toxins from the body completely missed the mark.
The real power of massage comes from the offering of meaningful touch that feels welcome and healing to the person receiving it.
The real power of massage comes when therapists provide a safe place to explore touch, breath, movement and awareness.
Bodywork is fun, playful, relaxing and nurturing.
I strive to stay tuned into pain research so that I can be a knowledgeable companion on your recovery journey.
I want to explore possibilities, and provide you with new tools to move through life with more ease and confidence - and less pain.