According to the Institute of Medicine of The National Academies more Americans suffer with chronic pain than are afflicted with diabetes, coronary heart disease and cancer combined. The estimated number of chronic pain sufferers in the U.S. is about 100 million. Though I’m using pain statistics from the U.S., this post applies to all in chronic pain no matter where you live.
During my yoga therapy training one of our teachers was renowned Canadian physical therapist, Neal Pearson. Also a yoga therapist, Neal helped us look at pain in an entirely different way—a way that revealed to us practices that can minimize pain and help such sufferers’ live more comfortable, functional lives.
The first thing Neal did was disabuse us of several attitudes about the brain, pain and our nervous systems. Western attitudes about pain include the suppositions that pain is a product of: tissue damage, irritated tissue, imminent damage or incompletely healed injury. All of these suppositions can be true in certain cases, but are not always true.
Neal shares a story about his teacher, Lorimer Moseley, pain specialist and author of the book, Painful Yarns. Walking in the Australian bush one day, Moseley felt a slight pain on his leg and supposed that he had been scratched by a briar. Rather, he’d been bitten by a deadly snake. The next time Moseley was walking in the bush he was scratched by a briar, but his brain sent exaggerated pain signals because of the previous incident of snakebite that nearly killed him. In this case we see that the brain and the nervous system can be wrong!
The purpose of pain is to warn us that we have been damaged or that we are about to suffer injury. Banging your knee is an example that Neal often uses. Not only does your knee hurt, but the muscles of your leg may go weak to keep you from making anymore potentially risky moves. Basically, the affected nerves send messages to the spinal chord nerves and onto nerves in the brain. The brain responds by analyzing the information and sending response signals to the body to deal with the situation.
The brain prioritizes the messages it gets from the nervous system in levels of importance. If you are fighting or fleeing you may sustain an injury. The injury may not be immediately apparent because your brain is occupied with the fight or flight. After you’re out of danger you may notice injury and pain that wasn’t able to get the brain’s attention in the heat of the moment.
Our pain detection and alarm system is complex. The neurons in the brain can “increase or decrease the intensity of the danger messages in the spinal chord.” (Understand Pain, Live Well Again, Pearson, Neal p. 15). Depending on the importance of the pain the brain can increase the signal intensity via the nervous system to warn you of the level of danger.
Now that we understand that the brain and nervous system can be wrong about the reality of danger we can begin to address chronic pain. Even after an injury is mostly healed (sub acute state) the brain and nervous system may still be on high alert and continue to send pain signals that do not reflect the present level of healing.
In my next post we will explore how pain is like vision and thirst and how we can retrain the nervous system and brain to understand that it doesn’t need to continue its level of pain signal notification as we heal.