Understanding Pain
We want you to know that you are not alone. Many people search online for a quick or simple fix to get some relief from pain. Are you looking for something that will get things back to “normal,” and the “one thing” that will get rid of their pain once and for all? There are plenty of articles, videos, and posts on all sorts of websites and social media that claim to have the answer:
“If you do this one exercise, your pain will go away”
or
“My {fill in the blank practitioner} taught me this stretch and my pain disappeared”
There are two problems with these kinds of claims:
- Pain is far more complex than just muscles, joints, stretches, exercises, and even injury
2. When the proposed “solution” doesn’t work, it can feel like a failure or another letdown
The Problem with Looking For A Quick Fix for Pain
Simplifying the experience of, and the solution to, pain down to a stretch or exercise is very misleading. If the promise of pain relief doesn’t happen, the thought can be “it didn’t work” and lead to frustration. The exercise gets tossed because it didn’t help with pain; this happens and all its other benefits are tossed out too.
Exercise, stretching, and other treatments are part of a pain management plan, not the solution in and of themselves. Of the many aspects that need to be addressed with an injury, pain is only one of them. Looking for one particular thing that will be the “fix” for your pain can lead to chasing symptoms and forgetting about the other aspects of an injury that may need attention (and may be contributing to pain). If the only goal is pain management, exercise, movement, stretches, or other active treatments won’t be used to their full benefits for injury recovery.
Enjoyable activities, appropriate exercise, managing stress, getting a good night sleep, eating well and drinking water, as well as social support (friends and family) are all aspects of life that have been shown to impact pain. They can help in a variety of ways:
These, and others, are supporting aspects of life that might need some attention. Again, they are not the “fix” for pain, they are health and wellness factors to take a look at and reflect on when recovering from an injury and managing pain. They might need some attention too.
More About Pain and Health and Wellness Factors
Sleep
Not only do our bodies recover when we sleep, poor sleep can impact the experience of pain. Setting up success for sleep starts during the day with putting sleep hygiene strategies and habits in place before going to bed. There are many ways to do this and you can get ideas from your team to help you get started.
Hydration
Dehydration can amplify the pain experience. It pulls fluid out of your tissues, muscles, joints, and cartilage, which can result in overall body aches and pains. Help you keep your tissues soft and pliable and support lubrication of joints by drinking water regularly when exercising; especially when you are sweating.
Nutrition
Our food is the building block of our health and wellness. Fueling our bodies with food that supports how much energy we are using is incredibly important for our recovery too. Being mindful of what you are eating is also important – fast food vs. a home-cooked meal and slowing down when eating can help with digestion. General advice on eating the recommended fruits and vegetables with protein for muscle health can be a great place to start.
Stress and Beliefs
Body tension may come from unmanaged stress and can impact how we move and how we feel. Understanding stress and changing your beliefs may apply to the aspects of pain as well.
Support At Home
Those living with persistent pain who feel support in their lives have reported lower pain intensity; lower pain-related disability; less depression and anxiety; better ways of dealing with pain; and overall better quality of life.
Movement
You are already working on this in your exercise program, if you have any questions, make sure you check in with your Physiotherapist and Kinesiologist. Keep in mind that exercise is also a stressor. Viewing it as something that can help you gain back control, confidence, and the life you envision yourself living can be a powerful tool on your more challenging days.
What is Pain?
You may already be working on a PMBJ exercise program with your Physiotherapist or Kinesiologist. Keep in mind that exercise is also a stressor. Viewing it as something that can help you gain back control, confidence, and the life you envision yourself living can be a powerful tool on your more challenging days.
One thing about pain that can be difficult to explain, but also grasp, is that pain is not a physical thing. Pain is something we experience. We aren’t able to pour ourselves a measure of pain in a cup and see how much there is, but we can explain the experience to another person. We can’t poke and prod a blob of pain, but we can point to a place that is painful.
This can be why it is difficult to communicate what we may be feeling with another person. This may also be why when someone shares about their pain, it can be misunderstood. People generally look through their own understanding, lens, or rely on their own experience to try and relate to someone else’s pain. The difficulty with this is pain is highly individual and many things can contribute to the intensity of pain.
Not all these things WILL affect how painful or pleasant something is, yet all of them can. This happens through setting expectations from past experiences and predicting the level of threat of future experiences. For an entertaining, and accurate, explanation of how this works with pain, watch this video by Pain Scientist, Lorimer Mosely.
Understanding how the brain and body work together, as seen in the video, is not the “key” to managing pain; yet, knowing that there’s more going on than simply damage, harm, or something sinister can be a relief and offer hope, especially with more persistent pain. In the appendix of this module, there are analogies for understanding pain which may help you work with and through it.
A Deeper Dive into Pain Science
Our bodies have specialized neurons called Nociceptors that respond to potentially harmful stimuli (heat, cold, sharp objects, poison, or any potentially dangerous thing). They won’t tell us what is going on, they only alert us to pay attention. Nociceptors don’t “know for sure” that something is harmful or damaging, they are communicating that something might be a threat. Why it is a potential threat could be for many reasons:
The more situations, activities, or life are viewed as threatening, the more pain becomes part of our life. Instead of giving useful information to keep us safe, these nociceptors become conditioned to protect us, whether it is an actual threat to us or not. Some or all of the above points may play a role in addressing pain in your life. Part of your job will be to identify which are relevant for you and start working on them in addition to exercise. Your team can help direct you to resources that will help guide that discovery process.
Other pain protective factors that might be worth exploring include:
Cognitive Factors
Positive beliefs, High self-efficacy, cognitive flexibility, acceptance, mindfulness
Emotional Factors
Stress Resilience, low anxiety, positive mood
Coping Responses
Adaptive flexible coping
Social Factors
Supportive family, good work environment, financial security
Physical Factors
Gradual physical loading, conditioned, adaptive functional behaviours
Lifestyle Factors
Physically active, good sleep, healthy body weight, non-smoker
A New Mindset Regarding Pain
Be patient when starting any of the ideas in this module. Changes in pain won’t likely happen all at once and will take time. The goal is consistency over immediate results. The more time we spend doing something the more confident we become, the situation becomes less stressful, and we get better at it. That applies to managing pain as well, it gets easier with practice.
Consider riding a bike. Do you have to think about how to do it? Or does it just happen now that you have learned how? Now, if you were given a different kind of bike, you might have to learn some new skills, or let go of some of the old strategies you used. A similar process occurs in both the bike example and managing pain. Both require practice and learning which create new neural pathways and new habits. It can be challenging, frustrating, and also rewarding as new skills and abilities are developed. This is rarely a straight shot to the goal. There will likely be ups and downs during the learning process and while creating new habits. Throughout, it will be important to focus on the things you have control over and identify behaviours that improve overall health and wellness.
Final Thoughts on Pain
We hope that you now understand is that pain is far more complex than just tissue damage or injury. Influences from many areas of life impact pain including what we have been taught or learned, believe to be true, and the overall health of our body. Pain can also influence the desire, motivation, and decision to start or stop doing an enjoyable or beneficial activity for recovery. It will be important to identify these things and work on them, whether on your own or with a team member or someone you trust.
For some, the most difficult thing about pain is accepting that it is part of recovering from an injury; and also part of being human. You may recall in your past when your pain helped you slow down when you had a minor injury; pain can be beneficial. Yet, when pain has been around for a long time, managing it can become the only goal and may impact the activities we like to do. Concerns of reinjury may limit what movements are seen as “good” or “bad.” Life can significantly shrink into a very small view of what you can do. Part of managing pain is expanding our lives, including more enjoyable activities and bringing meaning back into the day to day tasks of work and life.
If you are ready you to take the next step or need guidance with reducing pain, contact the Progression Muscle, Bone and Joint Clinic today for a free consultation.