Wellness Wednesday - Understanding Pain

This is a really well done blog from our Massage Therapist Donna Taylor.  I'm excited to present this to you as she has really done some research to bring you some awesome information.  Pain is a very confusing topic, and Donna does a good job of helping us make sense of it all. 

- Dave

As a massage therapist for over 15 years I have been asked several times,

“Do all people suffer from pain like this or is it just me?”

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I answer this question diplomatically, explaining that everyone is different and we can’t always predict how our bodies will heal themselves.

Though that is a true statement, I don’t know if it is enough of an explanation. So I decided to dig a little deeper, and I found a well thought out article written by Dr. Hendrick Visser called ,”Understanding Chronic Pain”.

It explained beautifully how the body processes pain and why some of us end up with chronic pain and others do not.  

 I am going to attempt to give you the reader a short overview of the main points of the article, in order to answer the above question.

Basically, once we do something that elicits pain; (i.e stub our toe, cut our finger, burn ourselves, etc) our body generates a pain signal in the nerve , which then gets carried through the spinal cord to the brain. The cerebral cortex part of the brain interprets the signal and perceives pain. The perceived pain then triggers a response; (i.e,remove your toe, stop cutting your finger, pull your hand out of the fire,etc

But how does the body know how many pain signals to send to the brain?

As the pain signal travels it goes through gates that act as gate keepers to the conscious part of the brain.  These gates are the spinal gate and brain gate and are controlled by a descending nerve fiber that releases “enkephalins” a type of endorphin.  Endorphins are the body’s own form of “pain-killers” and they are in charge of how wide or narrow these gates should open .  Based on how much these gates open will determine how many pain signals will be allowed to get through to our consciousness.  

 Two important things to note, 1) These endorphins are also released by the pituitary gland, which is responsible for regulating our hormone system and 2) Non-painful stimuli also travel this same pathway and have to go through these same gates .

Why is this important ? Think about the last time you cut yourself or bumped your " funny" bone.  What did you do, did you grab the injured finger or rub your elbow?

This action sends a non painful message to our spinal gate , which then competes with the painful message from the injury.

This " counter-irritant " as it is sometimes called, helps decrease the level of pain actually felt from the original injury.

When these gates do not open and close properly, they can not filter out the unnecessary incoming sensory input from various body parts causing exaggerated symptoms that are not a sign of bodily damage or abnormality.

The nerves that normally transmit signals up the spinal cord become irritable and fire spontaneously , intensifying the perceived pain in the brain .

The brain can no longer control the sensory input because it becomes overwhelmed and even a light touch can become painful , or you become exhausted from a flight of stairs. According to this article this is what someone with fibromyalgia experiences .

The brain learns early on how to filter through sensory input ignoring the non-essential senses and processing and generating appropriate responses for the more important input .

If we understand how the relationship between pain and injury is controlled by the opening and closing of the pain control gates found in the spine and brain, we can look at why some people develop abnormal gating responses leading to chronic pain and others do not.

Remember when we said that the nervous system controls these descending nerves from the part of our brain that controls our emotions? Well research has identified  6 emotional pairs  that are known pain intensifiers ; 

  • Fear/worry
  • Anger/bitterness
  • Guilt/regret
  • Loneliness/ rejection
  • Helplessness/hopelessness
  • Shame/values .  
  • These emotions have a negative affect on a persons mood and ability to deal with chronic pain.
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These emotions are primarily located in the middle part of the brain known as the limbic system. The sensory output from the limbic system goes to the hypothalamus and brain stem. These control most of our bodily functions and the hypothalamus regulates the pituitary gland which regulates our hormone system, including the release of beta-endorphins (pain-killer). 

The brain stem controls the autonomic nervous system responsible for our bodies fight or flight reaction or for relaxation.

In acute pain conditions the limbic system sends instructions to close the pain gate and protect us from pain . However when stress has become chronic and the emotional intensifiers have been dominate over an extended period of time, the limbic system loses its ability to close the pain gates . Chronic stress depletes the endorphins released by the nerve cells . This sets up the nerve cells to start firing spontaneously causing pain long after the injured tissue is healed.

 

When these emotional intensifiers are dominate the person experiences; depression, increase pain and the development of chronic pain.

However, when a person experiences positive emotions such as: 

  • Trust: security
  • Peace/kindness
  • Innocence/gratitude
  • Love /acceptance
  • Hope/passion
  • Worthiness / esteem

As these become dominant there is an appropriate endorphin response in the body and pain is minimized and pleasure is maximized. Understanding how stress affects our mood and increases our pain we can then look at what areas in our life cause us the most stress and discontent. From there we can decide to continue living the way we are living or make a choice to start making positive changes that will lead to managing pain and not being controlled by it.

- Donna Taylor 

Did what I say make sense? Confuse you? Or sadly ruin your day? Or did it totally blow your mind, and make you feel that much more awesome? Either way, please comment below, I'd love to hear your thoughts.