Carol Gardner, P.T.
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When you hurt your back, it’s common to assume the pain is stemming from your back. But did you know the pain could be caused by any part of your body that is compressed, stretched or has reduced blood flow?
“We now understand that pain does not exist until the brain determines it does and that we all experience pain differently without the degree of pain being related to the degree of tissue injury,” says Joseph Brence, a physical therapist and clinical researcher from The American Physical Therapy Association.
WHY WE HURT
Results from a study taken from the Journal of Bone and Joints Surgery shows individuals 60 or older who had no symptoms of low back pain found upon diagnostic imaging that 36 percent had a herniated disc, 21 percent had spinal stenosis and more than 90 percent had a degenerated or bulging disc. This study shows that a CT scan, MRI or X-ray cannot tell us why we hurt.
Stressful situations, anxiety and level of pain tolerance also can affect the degree to which you experience pain.
As a physical therapist, I help guide my patients to understand what they can do about their pain, especially if it has been ongoing for over three months and is then considered chronic pain. This type of pain, known as persistent pain, is related to a sensitivity of the brain signaling danger, even if there is no danger to the body’s tissues. The brain, when trying to interpret tissue signals of temperature, pressure, stress, movement, blood flow and immunity, can recruit more sensors to give the brain information and even dedicate more spinal cord and brain matter to the incoming messages.
The body becomes hypersensitive to any variation in the tissues. Since the brain has created this sensitive environment with multiple inputs — possibly from the same incident — it creates a big danger signal. In essence, it’s like a house alarm that normally sends off alarm bells when a brick has been thrown through the window, but now sends the same signal when a leaf blows against the front door.
Anxiety, emotional stress and nervousness all trigger chemicals in the nervous system to bypass tissue messages to the brain and sets off the alarm bells even before you think of moving or doing whatever it is that normally gives you pain.
HOW TO CALM PAIN
You need to move to get blood flowing to your tissues, change the position of your body and incite your nerves moving through your limbs and spine to offer normal messages to the brain. It can be scary to move when, previously, you felt the movement was painful. Understanding the neuroscience and the hypersensitive brain can be empowering as you learn to move and free your body from false pain signals.
LEARNING TO MOVE AGAIN
Gentle movement can be beneficial. First, focus on your breathing. Deep breaths from the diaphragm can help quiet the nervous system. Then, explore the least symptomatic movements you can do for one or two minutes in any position. Continue this exercise, and gradually branch out to different or new ways of moving.
Second, find something that gives you joy and move with it. Use mindfulness to focus on your body and feel the gentle movement of one section of your body. Then let it go, and move on to focusing on another section. This can help you let go of the fear of feeling the pain.
Eventually, you will graduate into positions or thoughts of activities that previously would have triggered a big pain response, such as lifting, sleeping, driving or working — also called graded motor imagery. Ultimately, graded motor imagery will help you return to normal activity, and correct the ability of the brain to change and abnormal swelling or inflammatory mechanisms.
You can do it. The more you know about calming your pain, the better life will be.