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Understanding Chronic Pain

Pain is one of the primary reasons athletes and others come to my office.  To most, pain is a result of an acute injury or due to a repetitive strain. Once the tissues have healed and the repetitive strain has been reduced tissues are generally fully healed within 3 to 6 months.  But for some people pain persists beyond this point.  This is known as chronic pain.

The frustrating part for many of these patients is that they want to find a physical or structural answer for their pain.  Many request, or demand, expensive methods of imaging, such as MRIs and CTs, in hopes of finding the answer.  Disappointingly, most of the time the results are normal.  They are normal because the injured tissues have healed and the pain is not being produced by the tissue but by the brain. Pain is produced by the brain in all cases, acute or chronic pain.  In the case of chronic pain, the brain is the problem and not the body.

“In the case of chronic pain, the brain is the problem and not the body”

In the past, Doctors would explain, “The pain is in your head”.  From the doctors point of view they are correct but when said that way patients think the doctor is saying, ” You are faking it.  Your pain is not real”.

Your pain is far from fake. It exists. Even though I can not even imagine what your pain feels I know it exists because you experience it. I know how intense it is because I ask you to rate it between 0 and 10 (10 being the worst pain you have ever experienced).  Sadly, we have no way to image the brain to show you that it is producing your chronic pain.

“Your pain is far from fake; it exists.”

Take 5 minutes to watch this video from Youtube which explains chronic pain and how to get over it.  I have highlighted some treatment tips, from the video,  which may help you towards your goal of becoming pain-free.

Video Notes:

  • To treat chronic pain we need to retrain the brain and nervous system
  • The treatment of chronic pain is complicated
  • Medication only helps to a limited extent. An “active form” of care is more beneficial
  • It is okay to use meds to help you cope, in the beginning but they should then be slowly tapered until they are no longer used.
  • Surgery is rarely the answer.
  • Consider how your thoughts and emotions affect your nervous system.
    • Pain alters your mood and increases your stress levels.
    • Use methods to help wind down the activity of your nervous system, decreasing your stress, improving your well being and reducing your pain
  • Consider the role of diet and lifestyle.  What is your nutrition like? Do you smoke? What is your alcohol consumption like? Do you exercise?
  • Look into the deeper meaning of your pain and its surrounding personal story. What was going on around the time your pain developed?  A worrying period of life can be associated with a worsening pain period.  Recognizing deeper emotions may also help with pain.
  • Consider your physical activity and function.  Start with activities that your body can do.  Do not start with exercises that cause a fear of potential injury so that the brain doesn’t try to protect the body by producing pain.

“Realize that the pain you are experiencing does not mean you are causing harm to your body”

Many people with chronic pain fear doing any activity at all out of fear of being hurt again. This often leads to disuse and deconditioning.  This ultimately leads a decrease in overall well being and further pain.  In addition, realize that the pain you are experiencing does not mean your are causing harm to your body. Remember, the tissues have already healed.

I hope this gives you a better understanding of chronic pain.

Dr Notley
Treating athletic injuries and work injuries as an athletic therapist/chiropractor since 2000

Originally posted on May 17, 2022 @ 4:36 pm