Explain Pain:Chronic Pain

Chronic Pain, brain, pain mechanisms

More than 1.5 billion people in the word suffer from chronic pain thats 3-4.5 of the population daily!! It maybe be surprising that I am or at least was one of these billions of people. I was diagnosed with CRPS as you may have seen from other blog posts. Lucky at the peak of my pain I was studying osteopathy and learnt about the mechanisms behind chronic pain. If you do want to read more about my story then check out the About me page. The understanding of how it worked really helped me to accept my condition and understand what was going on with my own body. So here it is:

How does Chronic Pain work:

When you have chronic pain there is an increase in the amount of pain sensors in the area and therefore also more chemicals in the area to set off the pain sensory. This is the brain trying to protect you. If you have the pain for longer the representation of that area in the brain can get larger and start to overlap into other area again to try and protect the other area around it to stop that from getting damaged. This can explain why often you can start with lower back pain but other time it can spread into your buttocks or up to your mid back. While this may sounds scary it is completely reversible. For more information about pain mechanisms in general check out Explain Pain:An introduction.

What happens when the pain continues even though it has time to heal?

If the brain still think that there is a threat then it will keep trying to protect you by causing you pain. The sensors in the damaged tissues give out chemicals when the damage has just occurred it increases the sensitivity. When this happens over a long period of time the sensory stay open for longer and can build up like a puddle in the rain. Due to the build up of the puddle in the tissues of danger signal the brain is being told there is more danger than there really is which in extreme cases can mean even cotton wool or a change in temperature could cause the person pain. Unfortunately I was one of those extreme cases while it seems extreme it is beatable you can retrain your brain, it takes time but you CAN do it!! The increase sensitivity should fade round the joint once the area starts to heal or when your body understand what the problem at that area is.

Central Sensitisation:

When you have been in pain for a long time you have an increase level of adrenaline which is a chemical that would get released if you were running from a tiger. Also for anyone who has been in pain it also properly doesn’t surprise you that a stress chemical (cortisol) also gets increased if you have pain for a long time. When you have too much cortisol it can be linked to longer recovery time, worry and depression. It is normal for the levels in cortisol to change throughout the day naturally normally being higher in the morning.

It controls many things including blood pressure, sweating, and emotions all which would be changed temporarily in a life threatening situation but is not good for you if you have to stay in that state constantly. If you are constantly in a state of threat it can make the opposite actions like resting difficult for example getting a solid uninterrupted night sleep

You can download this guide at: The A State of Health Clinic’s Website.


NOI group- Explain Pain
Wall- Pain, the science of suffering, 1999
Moseley et al 2004. A randomised control trail of intensive neurophysiology education in chronic low back pain

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