Chronic pain: do you really get it?

You step on a thumbtack, and yow! – your body pulls your foot back faster than you know what hit you.

You accidentally touch that hot plate, and eeek! – you’ve pulled your hand back off it in the blink of an eye.

‘’Pain is the message your body part sends your brain when your body part is being damaged’’…right?

WRONG. This is a huge misunderstanding of pain, especially the area of chronic pain or persistent pain. It is a big mistake to make. If you misunderstand your pain, it can actually impede your recovery.

So what is pain, then, actually? Pain is what is PRODUCED by your brain and nerves (your central nervous system, or CNS) in response to a THREAT to the body tissues. That’s right, a THREAT. It does not have to be real or true damage. In fact, in chronic pain, it rarely is. Instead, your brain senses the body is in danger, and responds accordingly. It actually puts together an individualised pattern of pain in order to protect you from this potential threat. Believe it or not, this is what modern neuroscience research teaches us!

Of course if you have persistent pain, it is very important to have all the appropriate investigations done to rule out (or at least tease out) any causes directly related to tissue damage. If nothing can be found – or if pain is out of proportion to what would be expected for the specific tissue damage – then you can be sure that your central nervous system (CNS) is playing a big role in maintaining your pain.

The complex pattern of pain that your CNS puts together can involve a contribution from multiple systems in your body. As well as pain, you might have emotional or psychological changes (anxiety or depression), muscular changes (tense, sore muscles that are bracing you to deal with your pain, or run away from it) circulation changes (heat or cold in the sore area), tissue changes (weak or fragile skin in the painful area) and hormonal changes, which can affect your energy, sleep and the health of your whole body. All of this put together is like a big personalised puzzle of pain! Putting together the different parts of the puzzle is very important in overcoming the persistent pain.

In summary, persistent pain (or chronic pain) is complex but enormously changeable. In order to solve the puzzle of your persistent pain, you need to be able to put the pieces of the puzzle together, and bit by bit, see the picture clearly. Retraining the brain is an important part of resolving chronic pain; retraining the brain in chronic pain in the vulva and pelvis is a particular focus of mine as a clinician.

If you experience persistent pain – regardless of the cause – you need to address the central nervous system. You may benefit from a physiotherapy session dedicated to learning about pain and what causes it to persist – and how you can change this. When you book in for an appointment, mention you are wanting ‘’pain education’’ – and if you can, bring your loved one with you, so they can understand your pain as well. If you are a female and pain is somewhere in the pelvis, you can also start work on retraining your brain by using my e-book Outsmart Your Pain.

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