Pain comes from the brain and is our body’s normal way of protecting us from harm. However, pain that persists over a long period of time may not necessarily be a reflection of ongoing harm or damage. The brain is constantly weighing up incoming messages from the body and environment. These may include danger signals from body tissues that are under threat or damaged. The signals are simply chemical and electrical messages that run up to and down from the brain. The brain will interpret these messages and decide whether or not we feel pain. This nervous system is made up of many different nerves and brain cells in the body and we refer to it as the “pain system”. There are two main types of pain: acute and chronic.
Acute pain lasts a short time while chronic or persistent pain is of longer duration (3 months or more). Acute pain typically signifies damage to bodily tissues e.g. a broken arm or a surgical procedure. It is a signal that we need to become more aware of the body part, to rest and help facilitate healing. This type of pain usually settles as the tissues heal. In some cases acute pain does not settle once the tissue has healed and goes on to become chronic.
Chronic pain is usually more about the pain system being sensitised and less about damage to tissues. When pain persists, the signal is no longer a signal of tissue damage but more about a hypersensitive pain system resulting in the brain’s interpretation of danger. Many things can contribute to the hypersensitivity of the pain system. Often our thoughts and feelings about the pain will keep the pain system sensitised e.g. thoughts and fear of serious damage or anger about the circumstances of the injury. Chronic pain often leads to reduced activity and results in deconditioning and further fear and lack of confidence about moving. When pain becomes chronic the challenge is to move away from a focus on the initial tissue injury and switch to modifying the brain interpretation of danger and winding down the pain system.
It is time to think differently about chronic pain: