Introduction to Pain

In this program we are going to look at how we understand pain.

The really exciting thing is that there are findings from neuroscience that gives us as clinicians real hope which also means hope for people living with pain. We now know that the treatments that we have available can help you not only reduce the impact of pain on your life but also help you reduce your pain.

Pain has a very important function it's really vital for our survival and when we have something that's causing pain that's a warning system that's sending messages from the receptors up to the spinal cord and then through to the brain which then lets us know that something needs to be done.

One of the ways that I find really useful to be able to explain how pain works and how we have messages that are modified or changed in the nervous system is that we have these filters or gates that actually change the amount of information that goes through to the brain. The seat we're sitting on, the clothes we're wearing even what we've had for breakfast, all of that information is going from the receptors up the spinal cord and towards the brain. So these filters have a hugely important role in controlling that amount of information so in a sense our brain doesn't fuse with the amount of information that we are getting at any one time. On the other hand though if a signal is really high so if we are experiencing pain that will open the gates and the brain will be able to recognise that something is there that needs to be addressed.

Yeah, acute pain and chronic pain are quite different...

and this applies not only to the way that we experience pain but also to the way that we control it.

So for acute pain the messages go up to the brain from wherever it's causing the pain but the gates in the spinal cord work very well and if we give something like a strong drug we can close the gate, turn down the volume on the pain and control it quite well.

So with chronic pain the gates are much harder to close and so the normal sort of treatments that we might use for acute pain, even strong drugs sometimes are not successful in relieving the pain so because of this we need to use other approaches that help us to manage chronic pain effectively.

Quite often I see people who come in with chronic pain and they've had x-rays, they've had scans, the've had lots of tests and it's very hard to find anything that seems to explain what's causing their pain and sometimes people get the message that it might be all in their head or their making it up and sometimes the damage or the disease that's triggering the pain may not be all that big but because the gates are open it's turning up the volume and so the experience of pain is much stronger.

In practice I see a large range of people who have different sorts of pain not only arthritis, nerve pain, shingles pain, pain from cancer, pain from auto-immune diseases such as lupus and all of these conditions are triggering pain but this concept of the gates is just as relevant and just as important in these people who have these conditions so that if that the gates are open and the volume is turned up that there experience of pain is even stronger and more intense because there is this amplification that's going on.

The good news is there is something we can do to close the gates and turn down the volume on our pain. What we now know is that there are pathways that come down from the brain down to the spinal cord that control these gates in our nervous system and these pathways coming down from the brain release chemicals.

Some of these are excitatory chemicals that actually open the gate and some of these are inhibitory chemicals which actually close the gate and turn down the volume and we know that thoughts and feelings change these pathways and release different chemicals. so for example if we're tired, or stressed, or anxious the excitatory chemicals are released which opens the gates and increases our pain.

But if we are calm and relaxed it releases inhibitory chemicals which actually close the gate and reduce our pain.

So our thoughts and our feelings are very important in terms of how we experience pain.

The really interesting thing that research has told us is all about this concept of neuroplasticity.

What that simple means is that the brain and the nervous system is constantly changing.

The good news is though that gives us hope, is that there are things that re-train the brain, if you like, to reduce amplification to turn down the volume of our pain.

There's a whole range of strategies that can be helpful for pain.

Things such as exercise, relaxation, distraction, meditation, diet. We know that all of these are helpful for dealing with pain and it's rarely one thing that's going to do the trick. It means looking at all of these things, finding out what works for you and then putting these in place.

People often look at me and think “Well... how can that really change my pain, my pain is severe, there's good reason for pain, for whatever cause, how is something like exercise or meditation or some of these other things that we've talked about really going to make a difference?”

The good news is that it does. I've seen those same people come back two months later, three months later, they've started to put these skills into practice and their lives are better, so it really can make a difference.

One of the things I talk to people about is that your not alone in managing your pain, there are people around you, it maybe friends, it maybe family but also your health professionals and it's good to include them in what you are doing and maybe develop a plan about how you’re going to move forward.

The important thing to remember is, this is not going to happen overnight.

Even though it well help it does take time and it does take practice so people need to give it some time before it needs to work and they also need to use these skills and put them into place as a regular part of their life.

But once they do it, that's when we start to see the changes happen.

To create your own plan for managing your pain, click on the health plan button below the video and download the PDF.

Print it out, after each video fill out the relevant sections.

You only have to fill it out once.

Take your completed health plan along to your GP or your health professional.

This is a great starting point to managing your pain.