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In today’s article, we’re going to be discussing pain – how exactly pain occurs, where it originates and whether it’s just ‘all in your head’. Starting off, what exactly is pain? There are many different types of pain – known as acute, sub-acute, or chronic pain. Acute pain is the type that occurs immediately following an injury, and is an indication that some kind of damage has occurred in the body. It’s a warning to your body that you are in harm’s way and need to protect yourself. The injury you have sustained may cause this acute pain for a number of days, but after 4 days it is classed as a sub-acute pain – this is where the tissues begin to heal. Chronic pain is more complex, as it usually persists beyond 3 months following an injury, past the healing process, and is not necessarily a sign of new or further damage to any tissues.

What Is Chronic Pain & How Does Chronic Pain Occur?

As we mentioned, chronic pain is when pain lasts longer than 3 months. After 3 months, there have been changes to the nervous system that has resulted in a ‘pattern of pain’ emerging. The injury has usually healed 3 months down the line and, by this time, the pain should have settled – but in some cases the signals can continue to be sent out by the brain. These signals may also come on for no reason at all. ‘Feedback loops’ that detect pain signals and send these messages to the brain, can actually change the function of the prefrontal cortex in the brain. Through this, pain can then be stimulated simply by anxiety of re-injury and social experience. These negative experiences can cause your body to be more susceptible to experiencing pain from behaviours that wouldn’t, in the average person, cause you pain – for example, light stretching or even just lightly touching someone in very chronic cases. Persistent pain responses allows inflammation to stay in the site of pain and cause more damage to healthy cells in the surrounding area.

What Can Increase Pain Messages?

There are some basic factors that can increase your associated with chronic pain – including smoking, poor mental health, obesity, intense physical activity, lack of sleep or poor diet. Mental health, in particular fear and anxiety of pain, has been associated with increased likelihood of chronic pain. Sufferers who have this problem may also find that they’re stuck in a constant cycle where their mental health is affecting pain levels – and vice versa. When in pain, it is common for people to decrease their activity levels, opening themselves up to muscles becoming weaker and tighter – which in turn can lead to the spine becoming unsupported. Weight gain is likely to occur due to decreased activity, meaning there will be more weight and stress on joints, which can in general lead to more pain experienced overall. We generally would recommend to stay active. Studies have found that a reduction in weight is likely to improve chronic pain because of the physical and psychological benefits. Exercise also releases natural endorphins, which can block pain signals and contribute to lowering chronic pain severity.

We know through research that people who smoke make up a large portion of people in chronic pain populations, however there is not enough evidence to suggest that stopping smoking completely will improve pain levels. This is because studies show that those who have previously smoked are more susceptible to experiencing chronic pain, than people who have never smoked, and less susceptible than current smokers. With that said, the further health benefits associated with quitting smoking may help with other factors linked with chronic pain, such as mental health, thus improve prognosis of chronic pain.

What Effect Can Sleeping Have On Pain?

Sleeping is when the body has time to rest and recover and is a critical part of lowering the risk of developing chronic pain from acute injuries. Again, although the physical benefits from regular quality sleep are clear, it is the psychological benefits that makes sleep important in chronic pain patients – such as the lower risk of developing depression. Good quality sleep has also been shown to improve levels of stress and anxiety which are contributors to increased sensitivity to pain. Deep breathing and meditation are techniques that could be employed before you sleep to help relax and improve overall quality of your rest. Not knowing these techniques can be a potential barrier to implementing this in your routine, but there are many mobile applications that can help with this. Meditation apps like Calm and Headspace often give a free trial period to test out the app before committing to a monthly fee, but are very effective at teaching you meditation techniques.

Nutrition & Pain Levels

Sleeping is when the body has time to rest and recover and is a critical part of lowering the risk of developing chronic pain from acute injuries. Again, although the physical benefits from regular quality sleep are clear, it is the psychological benefits that makes sleep important in chronic pain patients – such as the lower risk of developing depression. Good quality sleep has also been shown to improve levels of stress and anxiety which are contributors to increased sensitivity to pain. Deep breathing and meditation are techniques that could be employed before you sleep to help relax and improve overall quality of your rest. Not knowing these techniques can be a potential barrier to implementing this in your routine, but there are many mobile applications that can help with this. Meditation apps like Calm and Headspace often give a free trial period to test out the app before committing to a monthly fee, but are very effective at teaching you meditation techniques.

In summary, pain is an important, but complex, protective mechanism employed by the central nervous system and the brain to warn us that we may be in danger in order to protect us. This mechanism is vital in early, acute pain to allow the injured tissue time to heal properly. As the injured tissue nears the end of its healing phase, pain is no longer required to alert the body that the tissue is still in danger. However, in some cases these pain pathways can continue to cause an issue after 3 months, this is when chronic pain is established as a diagnosis. This means that, although pain does not necessarily mean the tissue is still damaged, the pain experienced is still very much real. By addressing chronic pain as a multifaceted problem and modifying factors in the the areas which contribute to pain, like increased physical activity to strengthen muscles, reduced stress with better sleep and better nutrition to reduce inflammation, it is possible to break out of the cycle of chronic pain.

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