Can you remember your school biology lessons? If you can, you might remember a diagram of a foot stepping on a pin and sending pain signals up to the brain. The brain would then send signals to tell the foot to remove itself from the pin, or the flame, or whatever that particular text-book writer had chosen as a painful stimulus.
This is our base understanding of pain as lay-people. We experience tissue trauma and pain, and our bodies communicate that to our brains who decide what to do about it.
But our understanding of neurology and pain science has come a long way since these text books were printed – and it turns out it doesn’t work that way at all!!
Everything you thought you knew about pain is incorrect!
This blog is going to dispel 3 big misconceptions about pain (and you don’t even need to be a brain-scientist to get it!)
Pain happens in the painful body part?
With the advances in brain scanning and neurological diagnostic methods, we now know that 100% of pain 100% of the time happens in the brain.
Special nerve endings called nociceptors pick up on the chemical signals for tissue damage and relay that information to the brain. The brain will interpret these signals to make sense of what our tissues are feeling. Our brains have an extensive back-catalogue of experiences to compare these signals to, meaning we can quickly tell the difference between burning pain and stinging pain; pressing your hand to a hot kettle and being stung by a wasp feels different – and our brains remember that!
Pain is equal to trauma?
The more pain you’re in, the worse you’ve hurt yourself – right?
Pain is moderated by the brain – meaning that the context of the pain can influence how badly we feel it.
People who experience a bad lower back pain, which becomes chronic, have changes detectable in the way the process signals from the lower back in the future, meaning non-traumatic stimuli can be perceived by the brain as painful.
A good way to understand this is to think about how a lukewarm shower feels on sunburnt skin – the water isn’t burning you, but your brain is hyper-sensitive to information describing temperature increase on your skin – so it hurts!
In the very same way, a brain previously traumatised by lower back pain will react with greater emphasis on mechanical stretch signals coming from the lower back in the future (hands up if you’ve ever “done your back in” picking up a pair of socks off the floor?)
Pain is always a bad experience?
Well, yes. But pain does have a very important physiological use – it keeps us alive. People with congenital defects to their nociceptive pathways (read: they just can’t feel any pain, ever) injure themselves very badly, are subject to infections, and die young consistently.
Another good thing to mention here, is that our brains are extraordinary in their capacity to learn.
We call this neuroplasticity.
Thanks to this mechanism, even if your brain is sensitive to pain signals from a certain body part because of a previous injury, you can train your brain with manual therapy and exercise to not be so reactive in the future!
It’s the long way around a problem for sure, but the rewards in our body’s function and pain relief are well worth the commitment. Ask your osteopath about how your rehabilitation exercises are influencing your brain at your next appointment!