Understanding Pain (and how to treat it)

Persistent Pain

You may have heard the term ‘chronic pain.’ A lot of people think this means bad or severe pain, but really, it means pain that keeps on going for longer than we expect it to. Because of this confusion, health professionals have chosen the word ‘persistent’ instead. It’s not quite as catchy, but it is a more accurate term.

 

Acute vs Persistent Pain

There is a big difference between 'acute pain’ and 'persistent pain,’ even though they might feel the same. Acute pain is short-term and tends to be more associated with damage or possible damage to your body. For example, if you sprain your ankle it is likely you will feel pain associated with the bruising and swelling. This is acute pain. Usually it will settle as your body heals because the affected part no longer needs protecting. Healing usually takes less than three months, even for quite severe injuries.

Some injuries have been known to take even longer than this to heal including broken bones but this does not mean they have to be painful for this long!

Persistent pain lasts longer than acute pain and often does not indicate ongoing damage, even though it may feel like it. In the past we assumed that this was because we had not healed after an injury, but for most people we now know that this is unlikely.

Instead, the pain is less to do with injury in our bodies and more to do with our central nervous system. It’s like the volume knob on our pain system has been left turned up like a radio stuck on ’loud.’ Persistent pain can take over a person’s life. It’s really important to understand that you can ‘turn the volume down’ again, but it often takes effort and time. It won’t happen by itself and you need to be patient in working towards it.

 

Fibromyalgia

Fibromyalgia is a term to describe persistent widespread pain and other associated symptoms that have an impact on a persons ability to function. It may affect up to 5%of the population (1 in 20). Other symptoms include; fatigue, unrefreshing sleep, cognitive effects (brain fog), irritable bowel, irritable bladder, pins and needles, skin sensitivity, headaches and sensitivity to light, sound and smell. The symptoms and the way it affects a person are very personal and unique.

We do not know exactly what triggers Fibromyalgia, but it is likely to be different for each individual. There may be a history of difficult life events or illness with a tendency to push yourself and overachieve. Combined together these circumstances may result in changes in the way that the brain and body handles signals resulting in an over sensitisation of the nervous system (increasing the loudness of the radio, as mentioned above). This results in pain sensation being produces in the brain without injury (like a fire alarm going off without a fire).

It is possible for Fibromyalgia to develop in anyone, as human brains are wired the same way but the symptoms will vary. Fibromyalgia does not respond very well to medication and people are often more sensitive to side effects. The mainstay of treatment is paced regular movement, rest and relaxation, understanding of your body and its capabilities whilst maximising your quality and enjoyment of life.

 

Self Management Strategies for Persistent Pain

Even though you may not feel like it, the best way to relieve pain and to re-balance your life is to keep moving. This doesn't need to be a lot all at once. Small steps at a time, paced around what you are able to do, will help you start to gain your life back and prevent it being ruled by pain. Your mood, thoughts, stress levels, diet and sleep patterns also all contribute to making your pain better or worse.

Remember how we described nerves as electrical-chemical computers that send messages up and down the body? When the body is injured, it releases chemicals that kick start messages in the nerves. The natural chemicals connected with tiredness, stress, anxiety or depression are very similar to the chemicals used to communicate danger or damage. In a sensitised (turned up) nervous system, chemicals released by low moods and associated feelings can ‘turn up the volume’ even more and make our pain worse.

 

Steps to help you deal with persistent pain:

  1. Accept persistent pain as a longterm condition that you can manage
  2. See if you identify with the pain cycle (see below)
  3. Set your own goals and pace yourself
  4. Incorporate regular movement you enjoy such as tai chi, yoga, walking, swimming
  5. Look at positive changes in your lifestyle and general wellbeing
  6. Build a support team around you including; relatives, friends, colleagues and health professionals.
  7. Talk with your GP about painkillers. Try not to get caught in the escalating opiate trap. Read about the Problem with Opioids
  8. Browse through our excellent resources below starting with the pain toolkit

The team here at Rolle are dedicated to help you on this journey, our GP’s, Clinical Pharmacologist Louise Greaves and Health Coach Julia Hammond are here to help with advice and support.

Here are some useful resources we think might help you to understand and treat persistent pain:

Download a copy of the pain toolkit here

Download the Pain Management Guidebook here

 

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