Understanding Pain

Full video transcript:

Everyone agrees that pain is a universal human experience. We now know that pain is 100 percent of the time produced by the brain. This includes all pain, no matter how it feels; sharp, dull, strong, or mild and no matter how long you’ve had it. You might have had it for a few weeks or months. This is called acute pain and it’s common with tissue damage. Say from a back injury or ankle sprain. And generally you have been encouraged to stay active and gradually get back to doing all your normal things, including work. Or you might have had it for three months or more. And this pain is generally called persistent or chronic because in this type of pain, tissue damage is not the main issue.

What’s less clear though is when you’re told you have chronic pain, is knowing what’s best to do about it. Well in Australia, chronic pain is a really big problem. In fact, one in five people have it. Having a brain that keeps on producing pain, even after the body tissues are restored and out of danger, is no fun. Some people say it still feels like they must have something wrong. But that’s just it; once anything danger is ruled out, health professionals can explain that most things in the body are healed as well as they can be by three to six months. So ongoing pain being produced by the brain is less about structural changes in the body and more about the sensitivity of the nervous system. In other words, it’s more complex…

So to try and figure out what’s going on, you need to retrain the brain and nervous system. To do this, it’s helpful to look at all the things that affect the nervous system and may be contributing to your individual pain experience. What can help is to look at persistent pain from a broad perspective and by using a structured approach in a plan, it’s less likely that anything important will be missed.

Let’s start with the medical side, firstly taking medication can help but only to a limited extent. It is the more active approaches that are necessary to retrain the brain. So using medications to get going is ok and then mostly they can be tapered and ceased. Some people also think surgery might be the answer but when it comes to a complex problem like chronic pain, surgery may not be helpful. So if you’re thinking of surgery, it is best to get a second opinion and to remember to consider all the things.

Next, it is helpful to consider how your thoughts and emotions are affecting your nervous system. Pain really impact on people’s lives and this can have a big effect on your mood and stress levels. All those thoughts and beliefs are brain impulses too but you can learn ways to reduce stress and wind down the nervous system. This helps with emotional well-being and can reduce pain as well.

The third area to consider is the role of diet and lifestyle. Now it turns out that our modern lifestyle may not be so good for us. In fact, what we eat and how we live may really be contributing to a desensitized nervous system. Looking at all the things like smoking, nutrition, alcohol, and activity levels and seeing if there are any issues is a good beginning and these things can go on your plan. Then there’s often enormous value in exploring the deeper meaning of pain and the surrounding personal story by stepping back and looking at all the things that were happening around the time the pain developed. Many people with can make useful links between a worrying period of life and a worsening pain picture. For many, recognizing deeper emotions can be part of the healing process.

Last but by no means least is physical activity and function. From the brain’s perspective, getting moving at comfortable levels without fear and where the brain does not protect by pain is best and you gradually restore your body’s tissues.

So to sum up pain, it comes from the brain and it can be retrained and when looked at from a whole personal broad perspective, gives you a lot of opportunities to begin. So give a helping hand if you need it.

Dr. Luis Fandos is a pain management physician from Babylon, NY.

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