14) Know Your Pain (part 2)
Meet physical therapist Rachel Palmer, DPT in the 2nd part of her interview. She explains pain. Pain is normal and the experience is your brain’s response to protect and heal your body.
Rachel received her bachelor of science degree in kinesiology at Indiana University and her doctorate in physical therapy at Mount St. Joseph University. She is a physical therapist with Baylor Scott & White Institute for Rehabilitation.
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➤SUMMARY
What are these pain sensors and how are they specialized?
The brain is our command center and has an alarm system. There are millions of sensors throughout our entire nervous system that can communicate about pain.
Nociceptors are the principle mechanoreceptor responsible for detecting tissue damage and are located throughout the body.
These receptors deliver messages through nerves to the brain. Receptors can be specialized. They respond to the following . . .
* Mechanical forces - pinch or pressure
* Temperature changes - hot and cold
* Chemical changes - allergens (outside) or (inside) chemicals released by cells, or carried in body fluids like lactic acid.
* The life of a receptor is short, they only live for a few days and then they are replaced by fresh receptor. So, your current level of sensitivity is not fixed!
What are the different types of pain?
There are two types of common pain that are acute and chronic.
* Acute pain is short-lived. This pain immediately follows an injury and involves tissue damage. It improves within a few weeks to six months. During this time it’s good to stay active.
* Chronic pain, in comparison, lasts longer than six months. It’s a result of an underlying injury and tissue damage is not the main issue. Chronic pain is more difficult to treat.
* There is a third type of pain that belongs in its own category, it’s called neuropathic. You may also hear people call this nerve pain. This pain occurs after an injury where there is no tissue damage at all.
When most people think about pain, they think about nerves. Can you explain what nerves are and why stress can make pain worse?
* Nerves are cords. They are about 50% ligament and about 50% neurons.
* As in most persistent pain, stress can make it worse. Nerves, especially damaged ones, can become sensitive to the chemicals you produce when you are stressed.
* This can be a bit of a vicious cycle. The brain concludes that you are under threat by virtue of this 'unexplained' pain, which makes you produce stress chemicals, which activate the chemical sensors, which fire danger messages, which tell the brain you are under threat, and so on.
What are some behaviors we can do to counteract the process that can cause pain?
* Help to buffer the immune system.
* To have an influence on the quality of one's life
* To be in control of your life and your treatment options
* To have family and medical support
* To have strong belief systems
* To have and use a sense of humor
* Exercise appropriately
* Movement is VERY helpful to dissipate the chemicals that accumulate in the system when you have pain.
* While these behaviors buffer the immune system, they are also known factors which can improve a pain state.
* Understandably, you start to avoid some activities and movements, which reduces your fitness and strength.
* Understand your pain so that you don’t fear it.
About 400 years ago French philosopher Rene Descartes (Decart) described the separation between the mind and body split. We know this is not true, especially in relation to pain. So is it true that the pain is all in our head?
* Yes, all pain is produced by the brain - no brain, no pain. This doesn't mean for a second that it is not real - much to the contrary.
* All pain is real. In fact, anyone who tells you "it" is all in your head implying that therefore 'it' is not real - does not understand biology. A deep understanding of pain is greatly empowering.
* Thoughts are nerve impulses.