To understand how to reduce pain or the risk of you getting pain, we must first understand what pain is and what can contribute to it.
Pain is a subjective experience that is different for everyone. It is a warning signal from the body that something needs to change in some way. Pain occurs due to an unpleasant sensory or emotional experience related to actual or potential tissue harm. It is understood that pain is a response of the brain following stimulus that has been sent to the brain.
There are at two main categories of pain acute and chronic. Pain can be further divided into three types.
Nociceptive: represents the normal response to noxious (unwanted) insult or injury of tissues such as skin, muscles, visceral organs, joints, tendons, or bones.
This pain results when a stimulus becomes more than the body can handle. The stimulus breaks our bodies threshold which results in our body reacting and showing us pain.
A good example of nociceptive pain is if you touch something that is hot our body will send signals of temperature up to the brain. If the heat source is significantly hot we will pull away and our brain will tell us that may have received a burn.
Neuropathic: pain initiated or caused by a primary lesion or disease in the somatosensory nervous system.
- Sensory abnormalities range from deficits perceived as numbness to hypersensitivity (hyperalgesia or allodynia), and to paresthesias such as tingling.
- Examples include, but are not limited to, diabetic neuropathy, postherpetic neuralgia, spinal cord injury pain, phantom limb (post-amputation) pain, and post-stroke central pain.
Inflammatory: a result of activation and sensitization of the nociceptive pain pathway by a variety of chemical mediators released at a site of tissue inflammation.
- Examples include appendicitis, rheumatoid arthritis, inflammatory bowel disease, and herpes zoster.
The causes that may stimulate pain are varied it can be of mechanical, pathological, traumatic origins knowing the difference and how to help prevent them or manage them can help you live a happy healthy life.
As a physio, I spend all day educating people on methods of managing or doing away with pain. It is necessary we understand the differences in pain to help diagnoses and to help guide our patients when other input should be sought.
I deal with mechanical pain most often. Pain that is caused by inappropriate or poorly controlled movements of the musculoskeletal system. Mechanical pain is where the bodies nociceptive pathway is stimulated. Other injuries such sprains and strains lead to inflammatory style pain, following a mechanical event that overloads a body tissue.
Pathological pain is pain that arises from sickness or diseases such as cancer gastrointestinal illnesses, heart attaches. It is important to recognise the difference and is some cases such as a heart attach the pain can present similar to other musculoskeletal pains so it is best to get the worse case investigated and ruled out.
Factors that impact on pain
Stress and anxiety
Stress and anxiety can have a negative impact on our mental well being as well as physical well being. No doubt you have heard someone say they keep their stress in their shoulders. It is known that mental stress can have a negative impact on muscle tone. Tight muscles contribute to many musculoskeletal ailments.
Keeping on top of your stress levels can be challenging. Exercise, healthy eating, talking about concerns, massage and mindfulness/meditation are a few ways to help reduce stress. If you are wanting to start up exercise and have pain it is worth while speaking to a physiotherapist to find out what is the best way for you to start exercising.
Having pain for a long period of time can have an negative impact on our mental state leading to increase levels of anxiety and depression. Interestingly should you have had pain for a long period and suffering depression, getting your depression under control positive impacts on your pain. So in some cases anti-depressant medication have shown to reduce pain in people.
Mindfulness means different things to different people and is a useful tool to moderate our feelings and pain. Through my work, I educate people on the different causes of pain and help them realise what symptoms are normal and what are problematic. Mindfulness is also useful in helping us moderate stress and anxiety, helping us as individuals see the bigger picture.
Mindfulness is taking the time to listen look and feel what is happening and to ourselves and our environment around us. You can be mindful of the taste of the food you eat and the feeling of a stretch when you stretch your calf. All you need to do in listen to what our body is telling us.
Mindfulness and pain is putting context to what it is you are feeling. Did you have an event occur to you that is likely to cause you damage? have you had medical investigation that show tissue problems? If not could there be another explanation to what you feel.
I was once treating a young adult women. She was not very aware of her body and had poor proprioception or body awareness. She was unable to identify her posture or where her shoulder sat in relation to her torso. Being not very worldly, she did not have a good understanding between discomfort, pain, tightness and weakness. This lack of awareness could be due to not participate in fitness or sport, not have experience muscle fatigue and other sensations.
My client proved difficult to treat because of her lack of awareness and due to my lack of comprehension of how unaware she was as this was foreign to me having been active an athletic my entire life. I have had far more physical experiences of fatigue and injury etc. Treatment was based heavily in educating her on what the different feeling she would be feeling are. The point here is that being mindful of what we are going through both physically and mentally can help us understand what is normal, pathological or what might be psychologically impacted on.
Beliefs and expectations
As a physio, I can see how pain and expectations of pain changes peoples response to the painful event that has occurred. It is very obvious among younger people and if you are a parent you may have seen how your child responds to pain. Often children who have not had an injury, show significant fear of movement or respond very poorly when they first experience an injury. This is also the same with adult however more evident among children.
I recently saw a patient who had a fall on their side. They believed they had hurt themselves significantly and that surgery was probably necessary. Impacting on this problem involved many further investigations instigated by the general practitioner. The scans showed nothing more than an ordinary injury. Unfortunately the doctor and patient believed the scans were necessary. The patient was then referred to a surgeon who believed some gentle stretching and strengthening exercises would help improve the injury in no time. Once the patient had been informed of this by his doctor, beliefs were changed and the pain had already improved.
Beliefs and expectation can change the level of pain we feel or our susceptibility to experience chronic levels of pain. One important thing to understand it that life is not without pain in some form or another. Pain does not necessarily mean there is a problem with your body. Seeking out your physiotherapist can help you have an understanding about pain which can help shape your expectations of what you should feel.
Misuse or overuse can lead to pain
Poor lifting technique, bad running technique and poor posture are common things that physiotherapist see as regular causes of pain. Our bodies have been designed to work in an efficient way if all our muscles have optimal strength and length. Injuries and habits over time can cause us to change the way we move to negative movement patterns with time, or over use of a body part with poor movement pain or injuries can develop.
Physiotherapists are trained to help correct imbalances in the body and restore good movement patterns or habits that will reduce injury risk
Over-training or inadequate recovery
You can avoid pain by avoiding over training and ensure appropriate recovery.
When we exercise we can cause our muscles to tire. When muscles tire they become tight, this tightness can contribute to injuries or can produce pain. It is important to monitor the activity load you put your body under and respond accordingly. It is useful to plan out your training load particularly when you are aiming for a competition or aiming to achieve a fitness goal. If you are not sure of how much is too much for you seek out your physiotherapist input.
When you exercise you should start with a warm up and finish up with a cool down consisting of stretches. Allowing appropriate recovery time between intense training sessions is important. It is often important to have a cyclic training load with low intensity, medium intensity and high intensity training days.
How these days are timed is entirely up to how your body responds to the cycle of training. It’s also very important to taper your activity down just before and event. This ensures your body has had adequate recovery time so you can compete at your peek.
Seek physiotherapy advice when unsure of the cause of pain often musculoskeletal pain is a sign that there is an imbalance in the body or the loads that the body is undertaking are to much. Pain that comes on without an obvious cause is a sign that there has be something building for some time. If the correction of the underline cause does not occur pain can persist.
Understanding pain and causes of pain is useful in helping fight off bad pain. If you are experience pain and you are not sure why seeking advice is worthwhile. Seeing your local physiotherapist is a good way to shed some light on why you may have pain and what you can do to prevent or avoid further progression of pain.
A bad night’s sleep and pain
Our bodies are constantly working and performing tasks that can eventually lead to fatigue. If your body is not given adequate recovery through a lack of sleep, stretching dehydration and many other factors that can impact on recovery you may suffer an painful injury.
How we sleep can also impact on our quality of sleep and therefore recovery. For a good read on improving sleep read Best 10 Tips for better sleep.
Sedentary life-style pain
In some instances, pain can be increase by inactivity. Exercise has shown to help moderate our bodies mental and physical health in many different ways. A common cause of pain in older people is due to arthritis. As we age we are more likely to develop arthritis. Arthritis causes joints to stiffen and can intern cause pain. Evidence shows that gentle movement exercise like Thai Chi, walking pilates, hydrotherapy and gentle weight bearing exercise can reduce pain and help restore or maintain joint ranges.
The current physical activity guidelines for Australia for adults age 18 to 64 are:
- Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.
- Be active on most, preferably all, days every week.
- Accumulate 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.
- Do muscle strengthening activities on at least 2 days each week.
If you are unsure of appropriate levels of exercise or what style of exercise will best suit you speak to your physiotherapist
What you eat can cause pain
Healthy eating in the long term can help you from being a statistic. Poor diet can lead to life-style diseases such as diabetes, heart disease and other diseases such as fatty liver disease. Diseases that lead to organ damage and degeneration of tissue can lead to pain of inflammatory and pathological origins.
There is also good documented evidence that eating a diet high in omega 3 fatty acids and tumeric can have a positive effect on inflammation and therefore pain. Additional eating foods that you may have an intolerance for or be allergic to can cause the inflammatory style pain. Think of what you are eating before you eat it.
A great recourse for understanding pain further is the International Association for the Study of Pain