After 3 weeks of talking it is now safe to say that with majority of chronic pain the tissue is not the issue
Comment and let us know if you were able to find a way to move for 3mins? Also what questions have come up now that you have 3 modules to go though and think about?
Here is your first metaphor (Taken from the book, Pain Neuroscience Education: Teaching People About Pain)
“The body has a living breathing alarm system that is always buzzing along checking for threats. When the alarm is tripped, it ramps up hitting a tipping point where it fires a danger signal to the brain. Once action is taken the alarm is designed to steadily calm down and life returns to normal."
"Unfortunately, 1 in 4 people the alarm is activated, calls for help and never calms down leaving an extra sensitive nervous system. Before pain your nervous system allowed you to do lots of but since developing pain the extra sensitive alarm system severely limits your ability to do stuff"
"To set off the alarm someone most break in a window or kick in the door. Once the window is broken or the door is kicked in the alarm goes off. The main job of the alarm is to warn you of danger.
When the alarm goes off and you wake up what do you do? You likily call the cops who come and invistigate.
Once the cops make sure all is well, the robber went away, the alarm system is turned down. Set at its normal level and ready for another potential danger, like another break in. It is therefore normal expectation that one danger has been assessed and elimnated, the alarm system will turn back down to its normal resting level.
However, some people do not respond well to break ins. The alarm woke them; there is a lot of stress and uncertainity; probably worrying about insurance rates going up etc... Additionally, it is quite normal to be worried about this happening again
With the increased worrying it might seem normal to turn the alarm down but not all the way, thus leaving the house with an extra sensitive alarm system. This new setting might indeed be more likily to activate if a window is broken or a door kicked in, but it also might allow the alarm to go off for unnecessary things like a leaf blowing by the window. This elevated alarm setting will most likily be fine for a day or two after the break in, but will make life difficult over time. Anytime a leaf blows by...ding, ding, ding!!! the alarm goes off. "
"It constantly monitors for threats, such as an injury, stepping on a nail, surgery or even emotional stress. This is normal and occurs in every person. When a threat comes along, the alarm is activated. Our alarm sends a message to the brain, which in turn makes us take care of the issue. For example, if you step on a nail, the danger message is sent to the brain so you can take action. This is normal and there to protect us. Once the threat is elimanted, the alarm is gradually turned down and we can go on with our life.
In some people, however, the alarm is triggered by an event such as a injury, surgery, emotional time in life or irratated tissue with some inflammation, but it never calms down. As with the leaf example, an extra sensitive nervous system will significantly impact your ability to do things you were able to do before. A big reason why pain persist is an extra sensative alarm system, even when tissues have healed.
Why do human alarm systems stay extra sensitive? Everything people go through during their pain experience keeps the alarm system extra sensitive
-Dealing with pain every day adds stress and can cause issues at home or work
-Treatments are not working, otherwise you would'nt be here
-You have been given several different explanations for your pain, which causes confusion
As long as you are stressed, confused, afraid etc... your alarm is likily to remain extra sensitive"
Yellow flags are psychosocial factors shown to be indicative of long term chronicity and disability:
-A negative attitude that pain is harmful or potentially severely disabling
-Fear avoidance behavior and reduced activity levels
-An expectation that passive, rather than active, treatment will be beneficial
-A tendency to depression, low morale, and social withdrawal
-Social or financial problems
In our previous lesson we linked to an image showing brain changes on a Functional MRI showing the decrease in the brains pain maps of a chronic pain patient post education and return back to the movement. The reason why our patients get frustrated, understandably, is that depending on how long/much your nervous system has changed the longer it will take to reverse these changes.
Here is an excerpt from the book "A Brain That Changes Itself", in reference to Ramachandran and his phantom limb learned pain studies
"Patients who had had the pain syndrome for only two months got better. The first day the pain lessened, and relief lasted even after a mirror session was over. After a month they no longer had any pain. Patients who had had the syndrome for between five months and a year didn't do quite as well, but they lost stiffness in their limbs and were able to go back to work."
We need to move daily to rewires our brain
This week we will be focused on trying to do 6 mins of cardio for 4 days. We will also be working on 3 sleeping assignments from our sleep blog. Reference Week 5 in your pain recovery weekly calendar
What can sleep do for you?
- Get sick less often.
- Stay at a healthy weight.
- Lower your risk for serious health problems, like diabetes and heart disease.
- Reduce stress and improve your mood.
- Think more clearly and do better in school and at work.
- Get along better with people.
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 🙂