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What is Chronic Pain?

Apr 20, 2020

Cathy Price, a pain consultant joins us today to talk about the science of pain.

Science of Pain

Here is a great video to explain what pain is:

The science bit of Pain…why it’s important to understand this…

Pain can often carry on not because the muscle , bone or ligament hasn’t mended but because the nervous system that told you about the problem hasn’t gone back to quiet mode.

Our nervous system sends lots of crackly electricity around our bodies with the brain trying it’s best to make sense of the information it’s getting. The electricity has to jump over gaps and at that point there is the chance to ramp up the signals (sensitise) or damp down the signals (modulate). So if we injure ourselves it often hurts a lot more the day after, this is because the signals have ramped up or sensitised the nervous system to the fact that there is injury that is ongoing. This has an enormous protective factor, making us rest and allowing tissues to heal. The brain notices, pushes the information to our conscious level and forces us to act differently.

The modulating part of the system ( damping  down bit)  can kick in if the threat of danger is greater from outside the body eg if we are in a car accident and we have broken a leg, but the car is on fire, we will have no pain whilst we are escaping until we are somewhere safe.  The brain and rest of the nervous system stop injury messages reaching our conscious level. Endorphins are examples of such modulators or dampers.

So all the time our nervous system is trying to get things right for our survival.

Sometimes that simply doesn’t happen. Sometimes the nervous systems dampers fail to function properly , as they are not perfect, and the pain Messages are too strong for their own good. At this point the brain gets confused and can push this information much more up to our conscious level. We then are in a position of having false information but no way of knowing what is truth.

The picture shows pain levels over time after injury…the curve shows what you expect to happen.

The arrow represents the point at which the nervous system can fail to wind down and the nervous system starts to malfunction. There are at least 19 different risk factors for this so it’s often hard to pinpoint why exactly this happened.

The problem is we then crave certainty and can spend an awful lot of time seeing lots of different people trying to get that certainty.

What’s needed then is a very clear PLAN….

Health care professionals can work with you to set goals to achieve your plan, it is always better to stick with one person rather than getting lots of different, and often conflicting opinions.

Cathy Price

Pain Consultant

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