The Search for What’s Causing Your Pain
When we experience pain, most of us look for one simple source to attribute it to. If we can find the cause, it can be fixed, hopefully with a straightforward solution. Alas, pain sources and solutions are rarely as neat and tidy as we want to believe.
Modern pain science has discovered there isn’t a one-to-one correlation between pain and damage or abnormality like used to be believed. Not only can we experience pain in the absence of tissue damage (e.g. chronic pain, phantom limb pain), but we can also have tissue damage without feeling pain.
For example, damage and abnormalities in an MRI used to be assumed as the cause of pain. It turns out “damage” and “abnormalities” appear pretty darn frequently in the MRIs of people without pain as well. In fact, a review of imaging studies found that 50% of 40 year olds without back pain have disc bulges!*
New Pain Science Reveals the Truth About Pain
The truth is pain is not purely physical. Pain is an experience created 100 percent by the brain. The brain collects input from a variety of sources, including emotion, memory, attention, habit and social connections to make its best guess about level of threat. The brain then doles out the pain signals it deems necessary.
How pain affects us therefore depends, at least in part, on our thoughts about and associations with pain. Things that provide us with a sense of calm and safety can dial down our pain, while stress, anxiety and things that trigger protective responses can increase the pain we feel. And just as “neurons that fire together, wire together” helps us when practicing a new skill, our system can also “learn” pain: the longer we have pain, the better we can become at creating experiences of pain.
While the evidence has shown the purely physical, mechanistic explanation of pain is incorrect, this old theory endures. After all, it’s what we learned growing up and how doctors have been trained. Plus, when we feel pain, it really does seem like we must have something wrong.
It can be frustrating, even scary to give up the search for a single cause of pain. For many people, the promise of a quick surgical fix is more attractive (even with its risks, recovery time and financial costs) than making changes to their diet, lifestyle or ways of thinking.
But I find the new discoveries in pain science tremendously hopeful. If our thoughts, emotions and stress play a role in determining pain, then we have the potential to change our experience of pain.
Ways to Help Reduce Pain and Re-Train Your Brain
Here are some simple things you can do that have been shown to reduce pain and re-train the pain system in your brain:
1. Understand how pain works.
Pain specialists often report patients’ pain levels lower just being educated about how pain works.
2. Keep moving and doing the things you enjoy.
According to leading pain scientist, Lorimer Moseley, “Movement is the most critical pathway to recovery and it is almost always safe to move.” Of course, use your judgment and refrain from activities for which you’re not ready.
3. Get regular exercise.
Exercise is good for the mind and body, including releasing chemicals known to reduce pain. With pain, you likely won’t be able to do the amount and/or form of exercise you are used to. While this can be frustrating and disappointing, see if you can be open to different or more gentle forms of exercise—you may actually find something new that you really enjoy!
4. Reduce your emotional stress and stay positive.
Stress and tension can increase the sensation of pain. And studies show that when people cope positively with pain, they feel better and recover faster. Mindfulness meditation and Feldenkrais are two great supports for calming your system.
5. Remember to breathe.
A Feldenkrais mentor of mine once put it bluntly, “If a person with back pain isn’t willing to breathe into their back, they’re pain isn’t going to get better.”
6. As necessary, manage pain with appropriate medications.
Especially at the beginning of an injury, medication can help prevent the cycle of pain creating a well-worn neural path.
7. Take an Awareness Through Movement class!
My classes incorporate most things on this list and help you re-train your brain and nervous system to reduce pain, improve mobility and think differently about what’s possible for you.
Unraveling pain is a journey. As with other aspects in life, we’ll reap far more when we approach this journey with acceptance and a willingness to engage in the process rather than searching for short cuts.
Recommended Pain Resources
• Video: Understanding Pain in less than 5 minutes, and what to do about it!
• Video: It’s Time To Rethink Persistent Pain
* Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations