Are you sensitised?

Many of us attribute pain to tissue damage. Have you ever thought your nervous system has a role in this?

Acute pain caused by an injury to your body is meant to hurt, it’s a protective response where danger signals are sent to the brain via the spinal cord and the output is pain, this is necessary, this is healthy. The pain is there to alert you to take action.

Research has shown that after acute injury (e.g a back sprain or even a fracture) our body has a time scale for healing normally 6-8 weeks, it can be up to 3 months in some cases. Generally by then we can return to normal activities and with no pain.

But here comes the interesting bit (or not so interesting for the person in pain!), sometimes after the allotted time for healing passes, the pain continues.

Pain is a tricky beast, ‘Pain is really strange’ (also the title of a great book by Steve Haines), it can be very confusing. For example let’s say we sprain our back and after this we have severe pain when bending forwards, say this pain continues and we are still getting pain with this movement 6 months later long after our sprain has completed its healing process. Therefore, it would be normal to think that the body part is still injured (I would have done prior to my post grad training). However that is not true, your body part is not injured, but the nervous system has learned that this movement causes pain and has learned to play out pain in conjunction with this movement, it has learned wrongly that this movement needs to be protected by pain; we call this sensitised movement. A sensitised system means the amplifier has been turned up on your pain, it’s a problem with your pain output system not your formally injured body part.

In clinic I use the analogy of a car alarm:

Imagine your alarm is your pain and the car is your body. A healthy functioning car alarm would only ‘alarm’ on a break in (and we can liken that to a physical injury such as on ankle sprain), but a sensitised car alarm is super responsive and may respond by someone brushing past it (light touch), the wind (atmospheric changes e.g cold) or just opening a door (moving your ankle normally). This learned pathway is worsened by fear of movement (kinesiophobia), fear of pain, fear of damage. In this way we can understand pain is over protective and what was once a useful response is now accentuated and a barrier to moving forwards.

Our system can be sensitised by what's going on in our lives or our past. One big factor is our stress levels. Our system can be primed for pain / reactivity by stress at work, having too much on our plate, the internal pressure we place on ourselves and the biggies like bereavement, divorce and redundancy. Consider these factors in your pain experience.

Without the correct knowledge, support and education we can get stuck in a pain cycle and faulty beliefs around the true cause of our pain. There is now scientific evidence that unhealthy patterns that were learned can be unlearned and simply by changing our beliefs about the true causes of our pain and work on stress relief, we move with less fear, less tension and less pain.

#pain #brain #sensitisation