Is the tissue the issue in people with pain over 2 months?

This module we go deeper into the question...

Hey guys welcome to part 2 of our treating chronic pain

Thank you for coming back today and sticking with us on this journey to take back control of your life from pain!

Comment and let us know if you were able to find a way to move for 2mins? Also what questions have come up now that you have another module to think about?

How Does Education and Movement Treat Pain?

By calming down an overly sensitive nervous system

Check out this link of the changes on brain scan of a patient with chronic pain post education (you will scroll down in the link, but if you are in the author or refernce section you have gone too far)

I tell my patients to look at the nervous system as an over protective partent. It was orginally trying to help you heal and protect you, but now it is making you have pain because it will not let go. By educating that parent that their child is safe and by showing them they are safe (this is what movement does) the parent will stop worrying. 

We are trying not to address everything at once, but I felt like we needed some clarification of what is happening. We will get into our first story next week unpacking this sensitive nervous system issue. 

Last week we introduced the chronic pain issue and we started reframing our thoughts on what pain is. This module we go deeper into the question i s the tissue the issue in people with pain over 2 months?

The tissue not being the issue is most likely bringing some questions to your mind so now would be a great opportunity to address other common misconceptions on pain

Answer true or false to these statements. *Adapted Moseley’s Pain Sciences Quiz

Receptors on nerves work by opening ion channels (gates) in the wall of the nerve?

When part of your body is injured, special pain receptors convey the pain message to your brain?

Pain only occurs when you are injured?

The timing and intensity of pain matches the timing and number of signals in nociceptors (danger receptors)?

Nerves have to connect a body part to your brain in order for that body part to be in pain In chronic pain, the central nervous system becomes more sensitive to nociception (danger messages)?

The body tells the brain when it is in pain?

The brain sends messages down your spinal cord that can increase the nociception (danger message) going up your spinal cord?

The brain decides when you will experience pain?

Nerves adapt by increasing their resting level of excitement?

Chronic pain means that an injury hasn’t healed properly?

Nerves can adapt by making more ion channels (gates)?

Worse injuries always result in worse pain?

Nerves adapt by making ion channels (gates) stay open longer?

Second-order nociceptor (messenger nerve) post-synaptic membrane potential is dependent on descending modulation?

When you are injured, the environment that you are in will not have an effect on the amount of pain you experience?

It is possible to have pain and not know about it?

When you are injured, chemicals in your tissue can make nerves more sensitive In chronic pain, chemicals associated with stress can directly activate nociceptive pathways (danger messenger nerves)?

 

 

 

T,F,F,F,F,T,F,T,T,T, F, T, F, T, T, F,F,T,T

Even for medical providers the quiz above is shocking and challenging because the science is changing what we previously thought we knew on pain

Lets get into the false answers so you can have all the science on this, hang in there with us we are getting to the point : )

When part of your body is injured, special pain receptors convey the pain message to your brain

At this time in research there has not been discovered a pain receptor in the body. Our bodies have nociceptors that are picking up on temperature (hot and cold), mechanical (tension/stretch/vibration etc) and chemical (ph changes and inflammation)

Pain only occurs when you are injured

What about pain with no injury? Yep, that can happen, too. Think about stepping on a rock or a Lego with your barefoot, it’s freakin’ painful! Or stubbing your toe on a piece of furniture. Even though it may have been just as painful as the broken ankle initially (we’ve all been there, right?), it doesn’t lead to injury, there isn’t likely to be any damage at all.

The timing and intensity of pain matches the timing and number of signals in nociceptors (danger receptors)

This ultimately comes down to what your brain perceived as a threat depending on the environment, nature/nurture with a person's perception of pain.

Nerves have to connect a body part to your brain in order for that body part to be in pain

You can go down a long rabbit hole with phantom limb pain, but the short story is amputees can feel pain in the body part that is no longer there

The body tells the brain when it is in pain

Remember we do not have pain receptors so the brain is what decides whether those temperature, mechanical, and chemical signals become interpreted as pain

Chronic pain means that an injury hasn’t healed properly

It is interesting to note that you can have tissue damage and not have pain, but not the reverse because it is an output of the brain. Remember the I have a bruise and do not remember hurting myself. What about pain with no injury? Yep, that can happen, too. Think about stepping on a rock or a Lego in barefoot, it’s freakin’ painful! Or stubbing your toe on a piece of furniture. Even though it may have been just as painful as the broken ankle initially (we’ve all been there, right?), it doesn’t lead to injury, there isn’t likely to be any damage at all.

Worse injuries always result in worse pain

A common example of environment is war time stories of people being wounded severly but not feeling pain until after the mission was completed. A less extreme example would be twisting your ankle in the street with a bus coming and you not feeling the pain till you are safe and on the side walk.

When you are injured, the environment that you are in will not have an effect on the amount of pain you experience

Researchers have found that if the environment is stressful, represents negative feelings, or has no sunlight or beauty, it will make patients’ pain worse and challenge all pain management efforts. A common example of environment is war time stories of people being wounded levelly but not feeling pain until after the mission was completed. A less extreme example would be twisting your ankle in the street with a bus coming and you not feeling the pain till you are safe and on the side walk. Are when your boss gives you a headache or your husband when he opens his mouth for a dad joke

It is possible to have pain and not know about it

It is interesting to note that you can have tissue damage and not have pain, but not the reverse because it is an output of the brain. Remember the I have a bruise and do not remember hurting myself story

We will slowly unpack this quiz throughout the future lessons, but the take away we want you to get at this point is we have massive misconceptions regarding pain that has been taught to us

 The reason why addressing these is crucial to your success is because if the tissue is not the issue and we are battling a sensitive nervous system then we need to learn to move in a sore but safe way gradually over time till we return to normal function

What would you start doing today if the tissue is not the issue in your life?

Imagine how great it would feel: to be able to find a movement that you can do pain free, to be able to reframe your loss of daily independence, and to be able to get back to doing something you love. Next week we will continue on this path of reframing what pain is so you can feel confident to gradually start adding movement back into your life

Movement is the spark your nervous system needs to unlock your long term potential of getting back your life

 If you find a movement you can do celebrate and realize you accomplished something massive because you have your first personal victory over chronic pain and you are no longer helpless

If you can not find a pain free movement reach out to us and let us help you virtually or in person. In my 13 years in exercise coaching I have rarely not been able to find at least one pain free movement, but in the rare cases where I could not I had different protocols for people who can not even think about moving without causing pain. Please feel free to reach out to us for the specialized help you need.

Home Work

Pull Up The Course Calendar

This week we will be focused on trying to do 5 mins of cardio for 4 days. Reference Week 4 in your pain Recovery Weekly Calendar

Pain Recovery Weekly Calendar

We are excited about what this class will do to reframe how you look at pain, which will get you back to doing the things you love in daily life again

We are so proud of you for undertaking this course and taking your pain head on

This process can be a lot, so do not hesitate to slow down to your own pace. You are not alone. If you are stuck and need more help do not even hesitate to reach out to us.  

Your life is waiting for you again on the other side of this course, till next time guys 🙂

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