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Let’s talk about pain…This complex experience is affecting millions of adults in the US.  When it comes to lost productivity and time off work, it is a huge contributor.  I am being vague here, because pain anywhere in the body that is persistent is the same physiologic process.  Huh?  That’s right, if your pain has been with you longer than 3-6 months, you have stepping into a process b which the nervous system, not your tissues are the primary driver o your pain.  Whether it is neck, shoulder, hip, back or pelvis, your nerves are in the driver’s seat. 

This is not what we normally think about when we think about pain. We imagine our cartilage is worn down, or a muscle is torn, or strained, or worse, a tumor.  Right?  Well, what really happens is your tissue heal, most tissue healing is done by 6-8 weeks in general. Once tissues heal, if pain continues it is due to you nervous system.  Your brain is the only organ that can produce pain.  It does this based on what it perceives as danger.  So, if you injure your neck in a car accident, the first 3 months of pain is legitimately due to tissue injury, swelling, inflammation a normal response that is your body working to heal itself.  But a car accident is often stressful, unexpected and dangerous.  So the brain is amped up. As long as you remain stressed, fearful, worried your pain will remain present.

What can also be a contributor to pain is mixed answers from the healthcare community.  Another example that I see in my clinic is this.  A young woman has pain with a gyne exam. She is told by her doctor that she just needs to relax.  There are many things wrong with this statement, and there are many things that can cause pain with exams. But when left ot our brain to decide, as humans we go to the worst place…”I am structurally wrong, I have a small vagina, I was not meant to have sex, I have a tumor”  And what do you think then happens when she goes to use a tampon?  Ouch. Danger. Then intercourse? Ouch. Danger. And this cycle continues.  When a provider says something is wrong without giving a patient education about what it could be and how it can be cared for, the brain goes to dark places.

Another example of this is a patient who has back pain.  Has had MRI, Xray, epidural injections, physical therapy, chiropractic and each individual provider is telling them something different as a cause of pain.  The disc, degeneration, muscle spasm, alignment problems, weak core, the list goes on.  Meanwhile, nothing is helping and pain just keeps on like the energizer bunny…and equally annoying!  The truth is that all of those things could be partially contributing to the pain, but that just because there is degeneration or disc irritation or muscle spasm, it doesn’t mean you cannot get well. 

The first and most important thing is to UNDERSTAND pain.  To recognize that it is not a signal from tissues, rather a process created by the brain because it senses danger or threat.  To understand how you can calm your nervous system, so that your tissues give your brain the correct information and it can process signals in a SAFE environment.  Here are a few tips to begin the process:

  1. Find a provider who is willing and educated about pain and can help you learn more.  At our office we spend time with each visit educating our patients about the brain and pain and how they can begin to heal.
  2. Deep Breathing.  This is a great way to begin to help our nervous system find a healthy balance. Check our or video instruction Here
  3. Aerobic exercise; No need to run a marathon or even a mile!  A 20 minute brisk walk is more than enough to calm those sensitive nerves.  Cant do even that? Then start where you can! Evan 5 minutes is better than none!
  4. Good Sleep.  Check out our sleep blog here
  5. Stress management: this can be through mindfulness, meditation, reading, cross words, whatever you like, and gives your brain a break from the day to day!
  6. Movement!! Our nerves love movement and blood flow, so simple yoga, stretching or gentle strength exercises are a great way to teach the brain we are safe, even when we are sore. Check out our video for easy movements with pain Here!

If you are struggling with persistent pain, I would encourage you not to give up.  The research and management of pain continues to grow year by year, and we are beginning to understand so much more about how the brain processes this experience.  You are not alone, your pain is real, and there is help and hope!

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