Pain happens in the painful body part?
With the advances in brain scanning we now know that 100% of all pain 100% of the time happens in the brain.
Special nerve endings in the painful area called nociceptors pick up on the chemical signals for tissue damage and relay that information to the brain. The brain will interpret these signals to make sense of what our tissues are feeling. Our brains have an extensive back-catalogue of experiences to compare these signals to, meaning we can quickly tell the difference between burning pain and stinging pain; pressing your hand to a hot kettle and being stung by a wasp feels different – and our brains remember that!
Pain is equal to trauma or tissue damage?
The more pain you’re in, the worse you’ve hurt yourself – right?
Pain is moderated by the brain – meaning that the context of the pain can influence how badly we feel it.
People who experience bad lower back pain, which becomes chronic (that is lasting longer than 3 months), have changes detectable in the way they process signals from the lower back in the future, meaning non-traumatic stimuli (that is perhaps a muscle being stretched or slightly strained) can be perceived by the brain as incredibly painful. This means that it can require less stress or strain on your low back to elicit a significant pain response.
A brain previously traumatised by lower back pain will react with greater emphasis on mechanical stretch signals coming from the lower back in the future (hands up if you’ve ever “done your back in” brushing your teeth or picking up a pair of socks off the floor?). If you have visited the clinic with low back pain you may have heard me talk about your back being sensitised. This is how this sensitisation occurs.
A good way to describe this sensitivity is comparing it to an overactive security system. People often have security lights in their front garden. They should light up when people are walking up their garden path and are nearing the front door. But we have all experienced them being set off by just walking past on the pavement or by a gust of wind. This is very similar to what Is happening with your low back. The threshold for what you brain perceives as a threat to your back is lowered and seemingly harmless movements can elicit a very painful response.
Pain is always a bad experience?
Well, yes. But pain does have a very important role to play – it protects us and keeps us alive. People who are born with defects to their nociceptive pathways (read: they just can’t feel any pain, ever) often injure themselves very badly without knowing, are subject to infections, and die young consistently.
So what can you do?
So if you have pain, whether it be low back pain or otherwise, what can you do? A good thing to mention here, is that our brains are extraordinary in their capacity to learn.
We call this neuroplasticity.
Thanks to this mechanism, even if your brain is sensitive to pain signals from a certain body part because of a previous injury, you can train your brain with manual therapy such as osteopathy and the rehabilitation exercises we provide to not be so reactive and sensitive in the future!
Thanks for reading, whilst i find this subject fascinating i do appreciate that it can be difficult to wrap your head around. It is vitally important that us manual therapists keep up to date with the latest research to ensure that you as patients continue to get the best care possible.
If you have any questions about your pain or are unsure if we can help please call the clinic on 0208 088 0442 or email firstname.lastname@example.org and i will do my best to help in any way i can.
Thanks for reading and have a great day!