Are You Actually Being Treated for Your Chronic Pain?
An Introduction to Central Sensitization
Hello, My Name is Pain.
If you are anything like me, you have lived with pain for many years as a result of an injury or condition. And throughout those transitional years, your life has significantly changed due to your pain and the related effects. It may feel as though you have many unanswered questions and as of yet, you haven’t found a method of treatment that has offered a meaningful solution. In fact, most treatment methods you’ve endured along your quest, have ironically, resulted in greater pain. Perhaps like me, you have even gone under the knife to help manage your condition but have come to find that your pain and abilities, only worsened. At this point, it feels as though pain has truly made a permanent home for itself and you are wondering, if and when, it will ever leave.
Well, If any of these characteristics sound like you…firstly, my heart goes out to you and secondly, I hope you will keep reading.
Rethink Your Persistent Pain
I’ll be real with you, since my spinal fusion surgery, it’s been hard to regain my footing. My pain is not only constant, as it’s always been, but even more unmanageable most hours in the day. I am having trouble sitting, standing and doing regular movements, which makes it difficult to lead a life that resembles anything normal. It’s also been clear for sometime that my clinicians were unsure what to do and my work with different physiotherapists resulted in worse and worse pain. Regardless of all the different strategies presented to me – nothing was working. In retrospect, knowing what I know now, this makes a whole lot of sense.
Due to a mixture of both motivation and desperation, I continued my search for answers and thankfully, my dear friend introduced me to modern pain science and a website site called, “Tame The Beast.” This site, produced by Dr. Lorimer Moseley, who is a highly renowned pain researcher, shares information and resources that help you to rethink your persistent pain. At this point in time, I wasn’t even aware that my notions of pain may be off. I mean really, I’ve had a pretty intimate relationship with pain over the years but lo and behold, turns out, I didn’t know pain at all. And perhaps…neither do you! Thats right, your current understanding of pain is likely outdated or an incomplete picture which is a major problem if you are trying to reduce it.
You may be wondering why no one has pointed you in the direction of pain science. But unfortunately, although this science is not new, it is not necessarily well known by both, people in pain and the professionals they see. There are many clinicians out there that are not educated or trained on this science and as such, haven’t integrated it into their services.
After a fairly in depth, initial review of pain science, It was clear that my ideas surrounding persistent pain were definitely lacking and needed to be refurbished. In addition, I quickly took note that the treatment strategies presented were not being applied to my case. And I became hopeful… Could modern pain science represent the missing pieces to my pain puzzle? I wasn’t sure, but I needed to become well versed in pain so I could find the right clinicians and more importantly, begin helping and hopefully healing, myself.
So over the past few months, I have been knee deep in persistent pain research. And let me tell you, It’s definitely not easy to comprehend just HOW complex and highly intelligent the human body is. And although, I am still working out all the biological details, the message from the top neuroscience researchers and modern pain science data, is loud and clear:
Where there is persistent pain, you may now have two problems:
The original one that caused(s) the pain
Central Sensitization or a A Hypersensitive System
When I understood just how problematic an over sensitized system can be, there was no denying that in order to reduce my persistent pain, I must treat the problem of pain itself, or in other words, retrain the sensitive system.
And that my friends, was the key I needed to unlock the mystery behind my persisting, worsening and spreading pain and it may be yours too.
Since learning about the role my nervous system plays in my pain, my entire mindset and approach to treatment has changed. For the first time, in a very long time, I feel empowered with knowledge and like I am headed in the right direction towards healing. It’s a long road BUT, I am finally travelling it.
I truly hope this information serves you and is also the start towards finding the support you need to not only reduce, but perhaps treat, your persistent pain.
So lets begin…
Central Sensitization is defined as sensitization of the brain and spinal cord.
In simple forms, this means your nervous system has learned to be a highly effective pain producing machine. How? Well, it’s very complicated lol but I will break down a small part of it for you.
When pain persists your system begins adapting and learns to act like a very overprotecting and highly reactive alarm system. As such, it is sending an abundance of danger messages to the brain and releasing danger chemicals. Danger, danger, danger!
Consequently, your brain will review these messages with other information and if it feels threatened, which would only seem logical since it was sent danger messages, it will produce pain to protect protect you.
The major problem here, is that the system is creating danger messages where there is no real danger.
In fact, overtime “a hypersensitive nervous system can lead to more intense pain, pain that spreads to new areas… [and] can make it so that normal movements – things that are not at all dangerous to your body and actually good for you – are experienced as extremely painful/dangerous.” (Understanding Pain: Live Well Again, Neil Pearson.)
Furthermore, as pain persists, our system unfortunately learns to get better and better at reinforcing this sensitized state, and it also calls on the other systems of the body to join in the dysfunction. Eventually, our internal environment is completely haywire and constantly communicating faulty danger messages, engaging fight or flight mode, releasing stress chemicals, becoming more paranoid and protective, trying stop the body from moving and continuously producing pain. (to name a few.) And for most people in chronic pain, this is all day, everyday. A truly sad and sophisticated mess indeed and if no one teaches you about this, an almost impossible system to reprogram. (Understanding Pain: How to Live Well Again, Neil Pearson.)
When sensitization occurs, even when the cause of the pain has healed or in other words there are no issues with your tissue, the pain will continue and this smart malfunction is what puts the chronic, in chronic pain.
Like an Orchestra
The informative book, “Explain Pain” written by Dr. Lormier Moselely and David Butler, does a wonderful job at illustrating the pain system, when they compare it to an orchestra.
“One way to think about how the brain works, including how it produces pain, is to think about it as an orchestra. A skilled orchestra can play many thousands of tunes. It can play the same tunes with different tempos, in different keys, with different emphasis, and with different instruments taking different roles. New tunes can be made up, old tunes revived, [and[ variations improvised ….A good orchestra can play all the tunes and can easily learn more tunes.
However, if the orchestra plays the same tune over and over, it becomes automatic, it plays by memory, and it becomes more and more difficult to play anything else. [And] pain can be thought of as [that] one [highly annoying] tune.
Orchestra with Chronic Pain
As pain becomes chronic, orchestra changes occur and it is like your brain has been playing the same [pain] tune over and over and over…. It is important to emphasize that when the brain is sensitised, it also draws in OTHER protective systems such as the sympathetic nervous system, endocrine system and the motor system. These systems and others can feed back into the brain and combine to perpetuate the pain tune….The pain tune is not a happy tune and it’s the same tune again and again… [And eventually] the pain tune starts to [play throughout and] dominate every aspect of your life – work, friendships, family life, hobbies, thoughts, sports, emotions and beliefs. (Explain Pain, Dr. Lorimer Moseley and David Butler.)
Treating our Pain System
The great silver lining about a learned hyper sensitive system, is that it can be unlearn too! And although, it may not be easy and can take a long time, it is possible. Developing a new understanding of pain is the most important step for people to accomplish as they work towards living and moving well again. (Understanding Pain: Live Well Again, Neil Pearson.) Explain the Pain Handbook says it best…”Our aim is to teach the orchestra to play all the tunes again.” (Explain Pain, Lorimer Moseley and David Butler.)