This blog will focus a little around Understanding Chronic pain.
Pain is a hugely complex mechanism, and this article by no means will cover those chronic mechanisms in detail. I should also say that if you had pain that is undiagnosed, this is by no supposed to serve as medical advice, so please consult a professional to help you ascertain the source of your pain.
It’s estimated that up to 35% of the population are living with Chronic pain in some form. Thats approximately 1 in 3 people. That means that if not you, then a significant number of people in our life will be managing a chronic pain condition.
What is Chronic Pain ?
As mentioned above, Pain is extremely complex. But in its simplest form can be categorised as being either ‘Acute’, or ‘Chronic’ . Acute pain is pain that has been present for less than 12 weeks. Chronic pain is defined as any pain that persists for longer than 12 weeks, or beyond what we would expect our natural healing times to be.
What can influence my pain?
There can be many MANY factors that influence a person’s pain. These factors are generally considered under three sub-categories – The Physical (biological), Psychological and Social. We broadly therefore consider pain under what we call the Bio-Psycho-Social model.
Biological
This is the Physical component of your pain or injury. It broadly covers the physical characteristics and mechanisms of your musculoskeletal pain, including the structures such as bones, joints, connective tissues and nerves. It considers the type of nerves that are affected, and conveying the pain mechanisms (think sharp stabbing pain vs a due ache). And it also covers the disease processes of conditions such as Osteoarthritis, including inflammation, and the changes to tissue such as cartilage. But it can also consider other associated systems which might influence things such as healing times and inflammatory processes, such as the digestive system, and the hormonal systems.
Psychological
This is where things start to get a little more complex. All pain sits in the nervous system. The control centre of this nervous system (including your peripheral nerves, and spinal cord) where pain is processed is in your brain. This makes it impossible for pain to be a purely physical phenomenon. All pain has to be interpreted by the brain, and this is a two way process.
When assessing any pain, we consider as much as we can including fear, past experience, past trauma, stress and anxiety, general mood. The list goes on. Our interpretation and processing of pain is as individual as our finger prints. We all have our own lived experiences that feed in to any musculoskeletal pain, and this has a huge bearing on our management and outcomes in relation to musculoskeletal pain.
Social
This can arguably cause things to be even more complex. The ‘social’ influence or impact on pain is a significant contributor to a persons pain experience. How pain affects our relationships, and vice versa. How pain influences our day to day activities, our hobbies, our mobility. How pain influences our work, or ability to work, and our ability to pay the bills. Did you know that one of the biggest risk factors for developing lower back pain is poor job satisfaction?
It considers how our pain experience influences our identity and our social status, whether this be in work, our families or friendship groups.
One of the most important things that we consider under this category is also a persons sleep patter, and the impact that this has on pain, and vice versa.
What does this mean for me and my pain?
As we said above, it is impossible to consider pain in any of these singular categories without significant overspill into both of the other two categories. Some musculoskeletal pains are obviously simpler in their presentation, and not all pain is made equal. But all pains will have some bearing on each of the categories outlined above. Pain that starts to spill over into the ‘Chronic Pain’ threshold often tends to be complicated, with more overspill.
So it’s important to consider your management of chronic pain across all three of these categories, with a bio psychosocial approach. Your management strategies with these linger term pain will often involve some physical rehab, but its also important to try and engage with other things such as mindfulness, pacing, changes to your diet, sleep hygiene.
We will look to cover some of these strategies in one of our future blogs.
In the meantime, check this video out, which is a hugely useful resource, and hopefully fleshes out some of the content of this biog.
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