In Part 1 of this physio blog series we spoke what is pain, and about the different types of pain.
In Part 2 of this physio blog series we touched upon how the central nervous system (the brain and spinal cord) contributes to pain.
In this 3rd part of the series on pain science we speak on what you can do!
Remember; as we touched upon in part 2, all pain is real pain.
Firstly, if you have stress, anxiety, or difficulty engaging in recreational activity… it is not your fault. You are human and doing the best you can!
Now that we have a better understanding of how pain works, we can begin to realize that pain ≠ harm. But, aside from realizing nothing dangerous is happening, how can we start dealing with the pain?
Think of it this way…. if our CNS (central nervous system) can be sensitized, it can also be de-sensitized. After all, it wasn’t always this way and it can be gradually guided back.
So how do we do that?
While Nociceptive and Peripheral Neurogenic Pain improve with medication, strengthening and stretching, soft tissue release, acupuncture, and other treatment modalities, CNS pain is different. The pain response of the body has changed, which is why those same treatment approaches don’t provide more than some temporary relief, if any.
There isn’t just one thing, but rather a combination of things you can start trying. Remember, it took some time to get to where you are today and the CNS is used to this being the new “normal.” There isn’t an on/off switch.
But starting some of the things outlined below will move you in the right direction.
- Come up with at least one functional goal. Something you want to be able to do. If you are at the start line and the goal is the finish line, what is the first step there? Better yet, if you imagine being at the finish line, what would the step just before that have looked like? And before that? Work your way back to where you are. Then start!
- Rather than focusing on specific strength and stretch exercises that isolate your joints and muscles, focus on global movement. That is, use your whole body. Go for a walk. Try pole walking. Or gentle yoga. Or aqua-fit classes. Or Tai Chi! (While social distancing, look into free online videos for yoga and Tai-Chi!)
- Explore new coping and stress-relieving strategies. It can be meditation, breathing techniques, therapy with a licensed professional (not even about your pain, just about how you are feeling overall), journaling, a gratitude practice (or even an excitement practice, where you think of at least 3 things you are excited for that are coming up in the near future!), spend time in nature (even if it’s the backyard!), create and enforce boundaries with people in your life (have a protected time that is just for you), etc.
- Make plans with friends! Specifically, people you enjoy spending time with. If you see them once in a while, make those meetings more regular (e.g. every other Thursday for lunch). If you haven’t seen them in a long time, call them up. If you have concerns about your pain while meeting, then keep it simple. It can be a coffee meet-up at Tim Hortons, or you can invite them over for tea and biscuits. When you get together, while it’s normal to share about your pain, commit to at least 75% of the conversation being about other things.
- Although cliché, commit to eating healthier. Nutrition does actually make a difference. You are what you eat!
- Seek help! You can speak to your Doctor about potential referral options. Also, ask your Physiotherapist more about the science of pain and other strategies you can work on together!
It is not a simple and quick solution always when you experience chronic pain or pain that persists. This is why consistently taking opioids or other pain medications is not helpful over a long period of time. Speak with your family physician and your pharmacist on how to wean off of these pain medications.