Tag: Brain

Understanding our pain

How well do you understand the pain you experience?

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”, which is an interesting concept in itself as the definition clearly states that pain can be tangible, or simply mean that the potential for damage is there.

The amount of pain you experience does not relate to the severity of the injury you have sustained- think how painful a paper cut can be even though it is a relatively minor injury!  Similarly, we can continue to experience pain long after the original cause has resolved, simply because the body perceives that we are still in danger; this is due to changes in the local tissues.

One common misconception is that pain is produced by injured structures- but we now know that pain, no matter where or how it is felt, is produced by the brain. Before our brain will tell us something hurts, it will first process a vast amount of information before deciding if we need to experience pain.  Have you ever cut yourself and not realised until you looked down and saw blood?  This is because your brain processed the injury and did not perceive it as a threat to warrant pain signals.  Pain relies heavily on context and the brain’s perception of further threat- if you bump into a lamppost, it will hurt, but will it still be painful if you’re about to be run over by a train? Unlikely, because your brain will realise the incoming train is life threatening !

Pain can be both a help, and a hindrance- for example, if we put our hand on a hot stove, the acute pain we experience tells us that we are burning ourselves.  However, persistent pain can be very unhelpful as often it does not indicate ongoing damage.  This persistent pain is like leaving the volume knob on our radios turned up to maximum- it can block out other senses and become very disruptive in our lives.

When we are left with persistent or chronic pain, it can be hard to believe that there is no ongoing damage, it is because this persistent pain is more to do with our nervous system’s interpretation of the information it is receiving.  If you were asked to do the same task all day every day, it wouldn’t take long for you to become very good at it, performing the task quicker and more efficiently each time- the body can do exactly the same.  It can become very good at sending pain signals, and can actually adapt so that it sends these signals more frequently.  The body can then become so sensitive that it misinterprets normal messages (such as light touch) and responds to them as if they were dangerous.  We call this process “sensitization”.

What happens when our nervous system becomes sensitized?

When we perform recurrence activities they become familiar to us, and we become very good at doing them efficiently.  Now try to imagine if these activities were painful to perform.  If we perform these painful movements for long enough, the brain will associate the connection between those movements and pain, to the point that even preparing, or thinking about a movement can cause pain.  This can be very confusing and worrying if we do not understand why this is happening.

Deep, unexplained pain can often cause more worry and anxiety simply because we cannot see what is happening, nor can we sometimes understand why it is happening.  As the definition of pain says, it is both a physical AND an emotional experience- the two go hand in hand.

Have you ever noticed your back pain gets worse when you are stressed at work, or not sleeping well?  Have you ever noticed your back pain gets better when you’re on holiday, relaxing in the sunshine?  There is a vicious cycle that exists between pain and anxiety, which can be hard to break.

What we focus on as practitioners is addressing the factors that have led to us feeling pain. These factors can be our overall physical wellbeing, social environment, health beliefs, mental health, and social environment.  We aim to progressively increase your activity and work to restore your confidence in movement as these will all help to reduce your pain levels, and help break that vicious pain cycle and turn it into a positive experience whereby more movement and confidence means less pain.

So how do I help myself?

If we learn to view pain as a motivator to encouraging us to help our bodies, we can start to work with it to get ourselves better.

  • Exercise. Implementing strategies to encourage more physical activity will help your body release  feel-good chemicals (endorphins) which will make us feel better, blood flow to the brain increases and so our ability to function and concentrate improves, muscle strength and endurance will improve.  Remember, as you start to become more physically active, you are likely to continue to experience some pain- however, hurt does not equal harm.  With practice, and focus, normal movement will return and your pain levels will decrease.
  • Set yourself realistic goals.  As humans we often set ourselves up for failure by setting unattainable targets (New Year’s Resolutions being a prime example), and so when we do fail, we lose the motivation to try again.  Set yourself an attainable target, such as being able to walk the children to school and back within three months, or being able to hoover the lounge without sitting down. Competing in your very first triathlon in a months’ time is NOT an achievable target for everyone.
  • Take charge of your pain. Learn more about it, read around the subject, understand your condition.  By increasing your understanding and addressing your thoughts and feelings about pain, you can actually affect your own pain levels by giving yourself more control over your pain.  No health professional can take your pain away from you, you must take control.  There are a number of resources available to help you learn more:
    –  www.paintoolkit.org
    www.knowpain.co.uk
  • What is your coping strategy?  You might think that the sympathy offered to you by friends and family is helpful, but we actually know that those with a more attentive, concerned spouse/partner will report higher levels of pain.
  • If you have been prescribed help, this must make sense to you and increase your understanding of your problem.  If something does not make sense to you, ask, we are here to help.  A good clinician will help you master your situation but you must feed back to them if you do not understand what they say.
  • Research shows that if you have a good understanding of chronic pain, you can feel more in control, make better decisions in your self-management of pain, and experience less pain as a result.  Taking simple steps to increase your understanding of pain, such as reading and understanding this blog post, means you are already making a positive step to addressing and taking charge of your pain.

Download our “Understanding Pain” resource here.

Three solutions to beating stress

When real or imagined stresses exceed our perceived ability to cope, we experience stress. This is not always a bad thing. Short term, manageable stress can help motivate us and facilitates learning and change. But what happens when stress becomes chronic or long-lasting? This type of toxic stress can have major health implications…

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Your easy shortcut to better health

Better health might seem hard to come by. With our sedentary lifestyles, poor health habits have an impact on our waistlines, brain, heart and posture. In a 2018 study published in the Journal of Applied Physiology, researchers at Liverpool John Moores University in England claim sitting for too long reduces blood flow to the brain.  Sitting has been identified as so damaging to our health that experts now say “Sitting is the new smoking.”

Now, here’s the shortcut to better health that you’ve been waiting for!

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Two reasons why your back still hurts…

Why do so many of us have back pain?

We (as a society) throw huge amounts of money at back pain. There’s new gadgets, research, more effective drugs, better surgeries and dozens more practitioners out there all touting to be the next big thing in curing back pain, yet back pain remains as prevalent as it ever was. In fact, it seems to be getting worse.

So why is it that back pain is still such an issue?

  1. Everyone is different. Gosh, wasn’t that a groundbreaking statement. Yes, well, forgive me for stating the obvious but, it’s true. If we treated your back pain the same way we treat everyone else’s, we’re not going to get very far, as unfortunately everyone’s backs behave differently (and misbehave differently!) That’s why all of these treatment that work for everyone else don’t necessarily work for you- because your back is different to theirs and you need to find the approach that works for you!  P.S. This is why whenever someone asks me if I get bored “cracking backs all day” I can answer with a resounding NO! a) Because I don’t “crack backs” and b) because I have to not only work out what’s going on and diagnose it correctly but also work out how best to treat it based on what’s happening and what you want! It’s not quite as simple as handing over a pill and sending you out the door. Blimey, how boring would that be!
  2. We’re treating it far too literally.
    This is the big one! So many treatments out there focus on treating the area of pain as though that’s the cause of the pain. Pain in the lower back, treat the lower back. Monkey see, monkey do. Do you follow? Well, there’s two problems there. Firstly, if it was that simple to treat back pain, it wouldn’t be such a massive problem. Secondly, if we isolate our treatment and just focus on the spine, we are ignoring everything the spine connects to (and you don’t need a genius to tell you that the spine connects to everything!) As such, treating just one thing in the giant jigsaw that is your back pain is going to end up in tears and a lot of wasted time (and money). Of course we need to treat the site of pain (duh, that’s where it hurts!) but pain in itself only tells us there’s a problem, not where the problem is or what it is. Treating the site of the pain is lazy- we need to look at everything inside your body that impacts on the area of pain and could, as a result, be affecting it. Then, we need to look at everything outside your body (like your job, hobbies, environment) and see if that’s having an impact too!

    back pain diagnosis treatment Rolf Rolfing neck pain treatment Hampshire Emsworth chiropractor chiropractic massage therapy osteopath physiotherapy
    Image source: siguy.ca

    As a really simple demonstration of this, do me a favour- Google “Cervicogenic headache.” Done it? What does it say? That it’s pain referred to the head from structures (i.e. soft tissues and joints) in the neck. So as you see, you could take a paracetamol or sit with an icepack on your forehead but as this isn’t the source of the pain, it’s not going to do much good in the long term. A good clinician needs to look further afield to find out what’s actually causing that pain.

    Have a look at the image below- see how forward head carriage can cause dysfunction in your back and thoracic extensors?! What a waste of time it would be just treating the back and not addressing the forward head carriage (i.e. the issue that’s actually causing the pain!)

    back pain diagnosis treatment Rolf Rolfing neck pain treatment Hampshire Emsworth chiropractor chiropractic massage therapy osteopath physiotherapy
    Image source: fixtheneck.com

So if back pain is really so tricky to treat, what can we really do about it? Here’s two super simple tips.

Feet back pain chiropractic chiropractor osteopath physiotherapy massage back pain neck pain treatment injury recovery Hampshire Emsworth Chichester Sussex1) Get in touch with mother nature. No, we don’t mean making skirts out of hemp and running naked through the wilderness (although feel free, if that’s your thing). We mean take your shoes and socks off and feel the ground.

The nerves in your lower back run all the way down to your feet for a reason! Your feet provide feedback to your brain that not only tells your brain where you are in space, but they also provide invaluable feedback to help stabilise your body. Stick some bulky trainers on to stop your feet from being able to feel the ground and those feedback signals sent to your brain get confused, which leads to instability. When the brain feels unsafe, or unstable, it’s going to make things hurt and reduce the amount of movement in the area.

(While we’re on the subject, where most people go wrong is that at this point, right when they have less movement, they strain against it to push the body beyond that threshold. As soon as you go beyond where your body is happy to go, the body has a habit of going into shutdown- it tenses up and produces pain to stop you from doing it again!)

Simply put- the more skin in touch with the ground, the more sensory input your brain gets, which it in turn feeds forward to your spine, giving you more stability and in turn reducing pain.

2) Breathe!
You’d think, given it’s something you’ve been doing your whole life, thatPosture Chiropractic work desk office neck pain injury help health pain back pain chiropractor Hampshire Emsworth Fareham Havant Osteopath Osteopathy Chiropractic Health Fitness Exercise Sport you’d know how to breathe by now. But I bet you don’t! Do yourself a favour- for the next 24 hours, try and pay attention to how you’re breathing when you’re moving. My bet is that you hold your breath when you’re performing dynamic movements. Why? Read on, dear friends and all shall be made clear.

Breathing is closely related to spinal stability. If you think of your body as a barrel, the diaphragm is the top, and the pelvic floor the bottom. The diaphragm regulates our intra-abdominal pressure and contributes massively to our spinal stability. So when our spine is unstable and weak, we hold our breath to perform movements. This is an ill-informed attempt by our brain to increase our intra-adnominal pressure and maintain spinal stability because it’s worried that if we don’t, we’ll become unstable and get injured. Pull that belly button in towards your spine and breathe OUT as you perform dynamic movements- this will engage the good ol’ core musculature and take the pressure of your diaphragm and stop relying on the diaphragm alone to provide spinal stability. 24 hours, focusing on your breathing, that’s all I ask. Being mindful and aware is key to changing your habits.

In a nutshell,  part of your treatment programme is going to involve teaching you how to breathe!

So there you have it!

Now you understand why back pain can be such a nuisance to treat. Fortunately, you’ve got those two simple steps to reducing your back pain. Doesn’t that sound like a great catchphrase?! Honestly though, if I could give one (okay, two) pieces of advice to every person I see in clinic, it would be those. Create some healthy habits to help your spine and I guarantee you’ll see an improvement.

Until next time…

Philippa Oakley
Chiropractor

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