Many of my clients come in seeking to address pain, whether it’s low back pain, a shoulder that won’t stop hurting, or fibromyalgia. Very few of them come to see me with an accurate understanding of how pain works. My goal in writing this is to provide some insight, because when you understand more about pain, it can be incredibly helpful for a successful recovery.  Here are some of the things we know about pain and how they affect the healing process that you might find surprising: 

Pain is always about protection. Anything that suggests you need protection makes pain worse. Anything that suggests you don't need protection makes pain better. It would be easy to think that pain is a sign that there is something wrong with us. This just isn’t true. Pain is there to help us avoid doing things that would get us hurt. That is why often after a serious injury like a broken leg, there is no pain, because at that point there’s no point for pain!  It is also why feelings of being unsafe, or overwhelming stress, can exacerbate chronic pain.  This is why seeing a practitioner who can coach you through your recovery is so important in the healing process. Shifting your attitude about your injury and addressing the emotional experience is one of the most important, scientifically validated actions you can take to heal from chronic pain.

Pain relies on context and cues and it happens entirely in the brain. That’s right, pain isn’t at the site of injury! This can be hard to wrap your head around, but pain is your brain’s interpretation based on reliable information of whether you are at risk.  Putting your hand on a stove can manifest as pain, even when the stove is not hot if your brain misinterprets it as hot. The pain is just helping you to avoid getting hurt. 

Pain is always real no matter what is causing it. One of the really unhelpful things healthcare professionals sometimes do is blame sufferers for not being good patients when they continue to complain about pain after treatment attempts. They may be frustrated that your symptoms are not improving when you follow their plan, or when tissue healing is complete and you are supposed to be out of pain. They might even think you are faking it, but this is just not helpful. Just because healing has completed doesn’t mean pain has ceased.  This might come as a surprise but tissue damage and pain are not well correlated. In fact, you can have all sorts of joint degeneration and have absolutely no pain. If you’re past middle age and you don’t have some kind of joint degeneration, you are in the minority!  That doesn’t mean it’s going to hurt or even stop you from doing what you love. You can breathe a sigh of relief knowing that most tissue repair happens in 6 months or less and just because it still hurts, it doesn’t mean you are fragile, or broken.  It is quite possible that while being in pain for a period of time, your nervous system has trained itself to be more sensitive to pain.  The good news is that we are amazingly adaptable critters. We  can learn how to make pain persistent during a stressful long term healing process, but we can also unlearn that sensitivity to pain and feel whole again.

Your immune system plays a role in persistent pain.  If your diet is poor, or we have an inflammatory or a compromised immune system it can play a part in nerve sensitization, lowering the threshold for what makes something painful.  That is why it is important to cut out inflammatory foods, especially sugar, and eat a diet full of fresh fruits and vegetables. 

Other things that can be helpful for addressing chronic pain are addressing overwhelming emotions and participating in activities that lower your stress level like meditation and exercise. Even if all you do is go for a walk, movement can be extremely helpful. Movement gradually suppresses the pain system, helps you learn new patterns, and gets you breathing. Movement is one of the best ways to recover, and even imagining movement is helpful.  In the bodywork I do with clients, we do a lot of movement that involves breaking the habit of sympathetic arousal around heightened sensation. If you want to break any habit you have to keep practicing a new habit and we do this with regularity over a series of sessions. I teach my clients to work at the edge of where they are comfortable to gently increase their capacity to move without pain. 

Here is an exercise that has a similar effect to what I do with bodywork, but that you can do on your own. This might sound crazy, but a colleague of mine who does trauma therapy workshops gives this exercise to address chronic pain: (drumroll please) …it is “dancing as if you are drunk”. The idea is to really let yourself go within the range of what doesn’t hurt. It may sound crazy, but if you can disinhibit around the bracing that goes along with pain it can have a huge impact. Try it if you aren’t convinced!  Make sure you are breathing and really enjoying it, and only go up to the edge of the pain. The exercise isn’t about pushing yourself, so just enjoy yourself and let go.

Bodywork, Movement, Coaching and lifestyle changes can all be helpful as a part of the healing process for chronic pain. If you are ready to explore getting out of pain, I would be happy to help. 

Here are a couple great videos to further understand how pain works. 

Here is a really helpful tutorial by leading pain scientist, Professor Lorimer Moseley. 

He also has a great website called on healing from chronic pain. Here is the video from that site.