Chronic Pain

The idea of pain generation as a result of body damage or injury is outdated. Pain and tissue damage can be independent of each other, particularly in chronic pain (over 6 months).

Pain, is defined as a sensory emotional experience (1).

Freedom in Movement
A body in health moves with ease. A body in poor health doesn’t have ‘elbow room to move’. Thus when feeling mechanically stiff in the body we have dis-ease (2).

My Danger-ometer
The social interactions in life, the concepts we hold, the narratives we grow up into, the workplace that contains us, and the friends, family and colleagues who influence us, can affect pain experiences.

Pain comes from Latin and Greek meaning penalty and later from French to include suffering.

More recently pain experiences have been explained in terms of psychology and morality.

Severe pain experiences do not have to be caused by degeneration, damage or a disc issue. From a spinal perspective disc prolapses and bony degeneration occur commonly (3).

Communicating Pain

Shown above is a simplified view of how to describe pain. Because it is at the point of describing a pain experience that a therapeutic relationship can begin. So why complicate it?!

The 4 aspects of pain above provide a framework for noticing improvements. Pain improvements are not always ‘light switch’ or ‘linear’ experiences. During the first 3 weeks of a treatment plan the improvement in your muscles and joints may only be noticed in one of the 4 aspects above.

Lee sees the change process of decreasing discomfort and pain(s) as a ‘Both And’ transition (see forgetting my old PIN number).

Slow Responder

When your symptoms are slow to respond, the pain you feel may be a compensatory pain, which is why the first three weeks of Care are the most important in which to trust in and follow Lee’s advice.

For a few unlucky people pain can be amplified at the spinal cord causing central sensitisation or abnormal brain processing. Typically here prognosis is fair with a timeline to begin recovery in months not weeks. Lee will talk to you in your physical or online sessions if he considers central sensitisation or abnormal brain processing are important to you.

Social Pain

Pain generated from Loss, bereavement, humiliation, conflict, and bad luck, all in a social context, are registered in the same part of the brain that registers physical injury. Chronic pain could start from being given the ‘silent treatment’ or from a slip or a fall and result in the same pain experience. Because the brain can’t tell the difference. This same part of the brain is called the Anterior Cingulate Cortex (ACC).

The ACC can be ‘cut out’ in a brain surgery procedure called a Cingulotomy after which people still report having pain but are not bothered by it. We are all equipped socially to help each other with individual suffering. Hence, in Lee’s professional role of helping with pain experiences, he is friendly, facilitating trust, the cornerstone of medicine.

References

  1. International Association for the Study of Pain (2016); Terminology; Pain
  2. Merriam-Webster Dictionary. The History of Disease: Lacking in ease
  3. Brinjikji P.H. et al (2014) Systematic Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. Am J Neuroradiol 10.3174/ajnr.A4173

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