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  • Courtney Cheah

Understanding Persistent Pain: An introduction

Updated: Feb 23

Chronic or persistent pain – that is, pain that lasts for more than three months despite medical intervention – is unfortunately very common. It is also often misunderstood. Understanding pain is an important first step to recovery – as the way we feel about the pain changes our experience of it.

Living with chronic pain can be lonely and troubling. As it goes on and on, even after the interventions of doctors and other health care professionals, it can be hard to keep hopeful about recovery. It can take enormous courage just to carry on.




If this is you, take heart. Pain is complex and often it can be about finding the right people to help you. It can also be very helpful to understand more about it, as it is not as simple as pain = tissue damage.


According to Professor Lorimer Moseley, the researcher associated with the chronic pain resource Tamethebeast.org, pain is not an accurate measure of tissue health. Pain is your body’s way of protecting you.


Pain is a warning signal from your brain. When you feel pain, it generates behaviour to keep you safe – such as moving quickly away from something that could hurt you, like an open flame. Yet sometimes your brain becomes overly protective and generates unnecessary warning signals.


According to Prof. Moseley, what can happen is your body learns pain. Just like with anything, the more it does it, the better it becomes at doing it.


The body is wired for protection. Specific neurons called nociceptors in the body respond to harmful stimuli, be it mechanical, thermal or chemical. They then send a warning message to the spinal cord, which then can send it on to the brain. The brain processes the information it receives and decides how best to respond. Often the response is movement - such as jerking away from an open flame; sometimes the response is pain.


Yet pain doesn’t always occur in response to a direct physical stimulus. Changes in your state of mind, such as thoughts or emotions, can activate pain signals in the body too. The way you feel can have a direct effect on your experience of pain.


According to Prof. Moseley, when the body learns pain, you may notice that the pain spreads, moves to somewhere else in your body or activates suddenly. You may feel that your movements are inhibited, or old injuries start niggling again. The pain could change quickly with your mood, or you feel like little things set you off.


This is all part of the body’s protection system. Inhibited movement is your body trying to stop you from moving a damaged area too much so it can heal. When the pain system is being overprotective however, this inhibition is unnecessary and unhelpful. In the same way, when you feel oversensitive to stimuli, such as sudden or loud noises, this is your nervous system in fight/flight mode. It's on high alert, looking out for potential threats to keep you safe - only it's been dialled up to 11 unnecessarily.


So, understanding all this, what is the solution? As the experience of pain varies from person to person, there will never be one solution that works for everyone. However, there are ways to retrain the pain system.


The goal is to make the system feel safe. Essentially, if your body doesn’t feel safe, it will generate protective signals. It also adapts and responds to feedback, so the less you move, the less ‘safe’ the body feels to move. Breaking this cycle can be a helpful strategy for retraining an overprotective pain system.


Retraining the pain system is a process, and the right guidance and support is paramount. Seek health professionals that are trained in pain science, and don’t be afraid to change if you’re not happy with them. The right fit is very important. I also firmly believe in having a health team - a range of practitioners of different disciplines to give you a full circle of care.


For more information, please check out www.tamethebeast.org. It is a fantastic resource in understanding persistent pain, and offers information about pain coaching and treatment.


This article is for information only. For further information, please consult your healthcare professional.


Resource


www.tamethebeast.org