What is long term pain and what’s happening in the body?

Most of us have at some point been in pain. You may break a leg, get burnt or tried picking something off the floor only to get lumbago. The experience of pain can mostly be connected to a certain situation, there’s a reason for us to be in that pain.  Being in pain can be uncomfortable, distressing or even touching on unbearable, but feeling pain has a clear purpose. Let’s call it our built-in alarm system, a signal that something “dangerous” has happened to us. If this built-in alarm wasn’t there we probably wouldn’t survive for long, constantly putting ourselves in danger. Pain is a reflex for us to move our hand from the hot stove, or a  signal to rest and heal a trauma. Once this trauma is over, the need for this alarm ceases and the pain will most likely subside. 
But what happens to a person if the pain doesn’t go away? If a pain is present every day for over three months, it is referred to as long term pain, or chronic pain. This doesn’t mean that the pain will be there for ever, only that is hasn’t disappeared when it should. I like to think about long term pain as an ultramarathon. There will be moments of low effort, a glorious “flow”, and there will be moments where you just wanna lay down and cry by the side of the road. 

Living with long term pain may affect us in several ways and cause the following:

  • Physical and mental performance may deteriorate
  • Sleep may be affected 
  • Deterioration of lust
  • Depression
  • Anxiety and irritation
  • Feelings of resignation
  • Social relations may be affected
  • Maintaining a family life may become difficult when you no longer can keep up with daily chores because of your pain or mental health

This subject is obviously wider than “it hurts!”. It’s important to understand the many different aspects of life affected by long term pain if you want to understand how we can manage and maybe even limit the experience of pain. I am personally a fan of the metaphor of every day life as a cup constantly filling up with stress, depression, lack of support, physical strain, frustration and a whole lot of more. Pain may eventually cause this cup to overflow and we suddenly loose our ability to deal with everyday life. I will elaborate on this in my upcoming posts.

The most important realization for me regarding my own pain has been that the brain controls our experience of pain. Hearing this, you may get offended and assume that what we are saying is that pain is imaginary  and all in your head. Surely that is not the case, but the fact is that all pain starts as a signal to the brain who will in turn interpret this signal and decide on the appropriate level of response. The more signals teasing this system, the more sensitive it will become. This is because the brain wil cleverly enough get better at things it does often, in this case picking up on pain signals from the body. A funny example on this is when I can barely drive my car during hot days of summer. The steering wheel cooled down by the AC will cause a burning sensation when touching my legs. Of course I knew that the steering wheel wasn’t hot because I was holding it with my hands, but this didn’t stop the very real feeling of it being scorching hot when touching my thighs. My brain interpreted the feeling of the cool steering wheel on my skin as getting burnt and this feeling would quickly escalate to unreasonably high levels although I knew this wasn’t “real”. This phenomenon is known as “central sensitization” and is very real, this doen’t mean that pain is imaginary or exaggerated. 

What’s clever with this is that the same principle will apply the other way around, we can train the brain to not listen as closely to these signals. With proper training, we can basically teach the brain to tune this alarm system down, realizing that we are not in immediate danger. Understanding this is the first step towards finding the tools for gaining a functioning every day life and has with many other actions helped me tremendously. How to do this and what other tools should be in your tool box will be dived into in my next post!

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