WHAT IS PAIN?
Pain is given different meanings, for some it is a warning, others a signal to stop, some think it’s their penance for some perceived wrongdoing. What pain is NOT, is a measure of tissue damage. What it IS, is a highly sophisticated protective mechanism.
DOES PAIN EVEN EXIST?
The biggest misconception first - there are no ‘pain’ nerves. What we have is lots of different nerve types responding to various changes such as pressure, stretch, temperature and chemical balance. These nociceptors (danger receptors if you will) when stimulated send their signals to various parts of the brain for evaluation.
Your brain will include previous experience, cultural and social reaction norms, the relative danger of the situation and other sensory information before you feel any pain. How you feel then is a subjective interpretation of events, and exists in your head as this emotion we call pain. Joint and skin pain tends to be sharp and intense, as our nervous system uses this to create a reflex movement away from whatever may have cause it. Your brain is interpreting the damage as potentially life threatening and you need to move. Pain is sometimes referred to as 'your friend', since your body is making you aware of a problem and is hopefully a stimulus to change your behaviour. This perhaps applies only to those dangerous environments where life is at risk, and for acute reactions to injury. Chronic pain conditions are somewhat different (e.g. fibromyalgia) since these conditions often involve incorrect processing of information in the brain, resulting in pain that may not be appropriate. It would unfair to say that pain in these situations is your friend.
An important issue especially in Bavaria is that a Vitamin D deficiency can in the early stages also present with muscle fatigue / tiredness, and also bone or joint pain (see our 'Vitamin D' ChiroNews). Since the official opinion is that a majority of the population is deficient, it may be worth considering having your blood level checked.
TREATING PAIN
Using pain medication, especially local anaesthetics, limits the function of these different nociceptors. So although you might be pain free there could be significant tissue damage. If you use ice to treat the pain such as during a sporting event and then immediately play again, your ability to adapt is equally reduced. The chance of further damage is much higher as your brain’s awareness of this body part is reduced due to the numbing effect of the ice. While often effective at pain reduction, the ice itself does not enhance healing, rather delays its onset(2). Heat by comparison in the early days of injury is almost always going to be detrimental to healing, although it may feel good. When inflammation occurs, which is typical in the first 1-3 days after injury, nociceptors are activated which gives you a protective (pain) buffer allowing your innate healing to take place. Heat treatment with chronic conditions is however often helpful, especially if chronic muscle tension is adding to your pain. The increased blood flow can help bring nutrients necessary for healing. How you feel organ pain is different. Most of your organs do not have nociceptors that respond in the same way, but the soft tissue around them does. You cannot for example have kidney pain, but if your kidney is inflamed and stretches the capsule around it, then you will experience pain from these connective tissue structures. Since there is no ‘danger’ that you can run away from, the type of pain experienced tends to be deeper, boring and not
IN REAL LIFE
Developmentally we are still ´stone-age´ creatures, so Developmentally we are persistent or recurrent pain is related to your brain assessing your environment as potentially harmful. So for pain that is chronic, there are often other issues to consider such as strength of the immune system, hormones your own ´mental´stress levels. As discussed in the ‘Stress’ ChiroNews, the more an event occurs, and is associated with repeated emotional responses, the more the brain builds a neural network representing this experience (pain). So dealing with a chronic problem is not as quick as doing something once, and expecting the brain to instantly re-wire itself so that the pain is gone. In the same way that practising a tennis swing once will not correct a technique error. What we´ve learnt and have incorporated into your chiropractic care plan, is the adjusting to help bring your body out of stress, and a series of daily activities to help boost the parasympathetic nervous system activity. High levels of daily emotional stress also increases Time is the mitigating factor with chronic or recurrent pain. Addressing the causative factors, be they chemical, emotional or physical, along with strengthening your body’s innate healing potential is the combination approach we take, but mother nature needs time to respond and heal.
REFERENCES
http://www.pharmazeutische-zeitung.de/?id=37629
J Athl. Train 2012 Aug; 47(4): 435–443. Evidence for RICE Therapy