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Why am I in pain? What can I do?

Why do you have pain?



Obvious! You strained / damaged something so it hurts, right?


Yes and no, pain isn’t as straightforward as we first thought.


First of all – Structural damage ≠ Pain.


This is a very important to remember especially if you suffer from chronic pain. Time and time again I see many clients who’ve had all the scans available, and some of them are diagnosed with disc issues etc. One thing they all have in common is obviously pain, one thing they DON’T all have in common is structural damage.

Studies have shown that more than 50% of people in their 30s (total 604 subjects in this literature review) have disc degeneration, all of these subjects in the studies are asymptomatic, no pain(1). In fact, they wouldn’t even know they had any damage without a scan.




So why am I in pain then?


Threat – in other words, sensitivity of your nervous system to certain parts of your body.

A good example of this would be that of an old injury that you had. Let’s for the moment pretend you had a bad fall years ago, you slipped on ice and landed backwards on your backside. Very painful obviously, but you got back up, looked around to make sure no one saw you (very important part), limped for a few steps, pretended nothing has happened, and carried on.


Scenario one

Now you might be lucky – you woke up the next morning and experience no pain whatsoever. Great. But skip forward to present day, you woke up this morning and had this unexplained back pain, came out of nowhere. You might take some pain-killers, you might do some stretches while you try to think what you did yesterday that might have caused this. You couldn’t think of anything and maybe blame the mattress for it.

This pain then become persistent in its nature, months later you’re still experiencing the same pain. Might even have become worse as time goes by.



Scenario Two

The unlucky version – you woke up the next morning and you now have low back pain. This pain doesn’t shift no matter what you do. Months or years later that pain has become a familiar partner in crime to you.


There are of course other scenarios, some of which doesn’t involve pain, but perhaps involve weakness etc. in your lower back.

Most of these scenarios have one thing in common – threats to your nervous system. Since that fall during that cold morning, your brain has become sensitised to some of the structures in your lower back, which means that since that day, every time you stretch / move / bend that area, your brain thinks you’re going to damage yourself.

And in order to stop you from damaging yourself, your brain creates pain in that area to stop you from moving it efficiently.


Yes, pain is created within your brain, not ‘in your head’ in a psychological sense, but in a neurological sense. It’s real, it exists, and it’s not imagined.

This applies to all musculoskeletal pains, not just lower back.


PAIN IS USEFUL, ESSENTIAL. YOU NEED IT TO SURVIVE!


Pain immediately and shortly after a physical injury is very important to stop you from further damaging or infect the area. You would live a very short life without it.

But we know that all injuries / damage would heal up as much as it can after 6-8 months.

Any pain you experience after that is most likely an old fire alarm that hasn’t been reset, even after the fire has been extinguished.


What shall I do then?


Firstly, consult your GP / consultant if you’re concerned, or if your symptoms have worsened all of a sudden recently.


Move.

One of the best ways to desensitise your nervous system to your area of pain is to move that area in the range where small amount of pain is acceptable. You need to re-educate your brain about the area in question, it needs to know that you can still use that area without fearing that you’ll damage it again.



This is also helps increase the circulation in that area, removing inflammation (which causes pain) in the process.






Then check your diet. When you’re suffering from chronic pain, diet has a big role to play in terms of inflammation.

Reduce processed food, control your intake of highly sugary food, make sure you’re getting enough vitamins especially Vit. D. Ensure your water intake is sufficient.

There is a wealth of knowledge out there on the internet about anti-inflammatory diet, too much to list them all here. Also search for foods that can improve brain health.


Next on the checklist is sleep. Are you getting enough shut eye? For most people 6-8 hours is the average amount of sleep needed to be fully rested (it is not the case of the more the better, you need the right amount for YOU).


Again lots of information about sleep out there, most important thing in my opinion is getting a regular sleep schedule, even on the weekends.

Without adequate amount of sleep, inflammation will build-up both in your body and brain.


Stress level check. Which one do you think hurts more: lower back pain while you’re having a very stressful day at work, or lower back pain when you’re in Santorini sipping Malibu?

Find a way to de-stress yourself regularly, this could be meditation, breathing exercises, physical exercises, etc.


In many cases, doing the above would help them improve their pain symptoms significantly. But there are cases where the threat to the nervous system is so that help is needed on top. In these cases, seek help from bodyworkers – physical therapists, pain specialist, personal trainers, movement specialist etc.



Not all of them will be able to help you, it really depends on your nervous system. If you’ve tried a particular physical therapy and it didn’t work for you, try another. How your body respond to certain types of treatment differ from person to person.


Once you are out of pain, movements and exercises are very important to strengthen your body so that you are less likely to reinjure yourself.


Pain is a huge topic and ongoing researches are still happening to further understand how pain works. There isn’t a cure-all method or pill you can take; pain is complicated and it’s different for everyone. Just know that there is always help out there for you.


Hope this has been useful. If you have any questions, please don’t hesitate to contact us.




1. Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., Halabi, S., Turner, J. A., Avins, A. L., James, K., Wald, J. T., Kallmes, D. F., & Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology, 36(4), 811–816. https://doi.org/10.3174/ajnr.A4173

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