by Catherine Lewan, PT, DPT, CYT, CPI
As a therapist who treats people in pain, I’ve witnessed many who consider pain to be “the enemy.” But the road to recovery often requires a change in perspective. Although pain may be, well, a pain, it exists to protect us. It tells us, “Don’t touch that!” when we grab a hot pan. It helps to keep us safe as we move through the world. Instead of thinking of pain as the enemy, it may be helpful to start thinking of it as a friend.
Of course, someone who only warns you of danger after you’ve injured yourself isn’t very helpful. Pain can sometimes feel like the friend who sarcastically tells you, “The stove is hot,” after you’ve scalded yourself. But, like a protective friend, pain can also warn you of these potential hazards before you injure yourself. Pain processing occurs in the brain, and your body has the ability to recall things that have caused pain in the past, so it can clue you in to possible dangers.
Perhaps, however, you’ve had a hypervigilant friend—someone who comes up with potential dangers even when you are perfectly safe. My sister recently reminded me that our mom used to make us wear life vests when we played on the swingset. The swingset was much closer to the house than a nearby body of water, but to ease her mind about the possibility of us wandering off and drowning, we had to swing in coast-guard approved floatation devices. Like an overly protective loved one, pain can sometimes go overboard when it comes to keeping us safe. When the nervous system is hypervigilant, it doesn’t just warn you with a kind word of caution. It makes sure you listen by creating pain, or even by making the pain louder until you heed the warning and take action—as is often the case with persistent chronic pain.
The nervous system has a remarkable ability to adapt, and it can quickly go from your cautious-but-helpful friend to a not-so-helpful prison guard who won’t even let you get out of bed. If you’ve been told your pain is chronic, it is likely that your pain system is set to overdrive. So how do we get our pain processing to re-calibrate and behave more like a helpful friend? Well, it turns out that simply educating yourself about pain physiology is a good step toward improving your relationship with pain. Studies have found that learning about pain reduces pain and disability—so even just reading about how pain works can help you manage your symptoms.
If you can recall a time when you were uneducated about a particular bodily symptom, perhaps this will seem obvious. When we don’t know why something hurts, it is human nature to worry about what could possibly be wrong. In its efforts to protect you, your brain will conjure up images of the worst possible scenarios to motivate you to take action. Unfortunately, worry and anxiety increase your brain’s perception of danger, which can in turn increase your pain levels. When you learn that your ankle still hurts a year after spraining it due to heightened pain processing (not a stress fracture, bone tumor, fraying ligaments or whatever your brain came up with) and that it is completely treatable, you can breathe easy and you might even notice that you already feel better.
Ready to learn more? Here are some awesome free resources for pain education, generously shared by some of the leading experts in pain science:
- Joe Brence: 9 things you should know about pain
- Neil Pearson: Life is Now Pain Care
- Neil Pearson: Overcome Pain 1, Overcome Pain 2
- Greg Lehman: Free Download for Pain Science e-book
- Understanding Pain: What to do about it in less than 5 minutes
- Lorimer Moseley: TEDx Why Things Hurt
Remember, the goal isn’t to eliminate pain—we just want it to be more helpful in its efforts to protect us. For more on how pain can occur in the absence of true danger/tissue damage, see our previous blog about chronic pain. To determine how hypervigilant your pain system has become and for further guidance on how to manage your unique pain experience, please seek out a skilled physical therapist who is well educated in pain science. We hope that, with these resources, you’ll soon be on your way to a better relationship with pain.
Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 2011;92(12):2041–56.[PubMed]
Moseley GL, Hodges PW, Nicholas MK. A randomized controlled trial of intensive neurophysiology education in chronic low back pain. Clin J Pain. 2004;20:324–30. [PubMed]
Wojciechoski M. Keeping pain out of the red zone. PT in Motion. 2017; 24-31. Print.