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When you first get hurt, pain is your brain’s way of telling you that something is wrong and that you need to attend to it. Nociceptors are nerves that detect changes in pressure, chemical balance and temperature that may be dangerous to you. The brain has to evaluate this information and does so in the context of your social norms, beliefs, and your expectations. The brain decides if the body is in danger and then triggers a pain response based on that information. Pain protects us from danger: but what if pain persists?
When pain persists, it is known as recurrent, persistent or chronic pain. This is pain that persists long after the injury and tissues of the body have repaired. It is always important to see your healthcare provider to rule out any other medical conditions and clarify what is causing your pain.
Acute pain is pain that is initiated to protect us from danger and improves and eventually resolves over time as tissues begin to heal. There is a clear progression back to normal pain-free function. But what if pain persists?
Chronic/persistent or recurrent pain extends beyond 6 months with no marked improvement and is still present because the nervous system has become over-sensitized and perceives regular day to day activities or usually benign events as threats to it’s safety. As we stated in a previous blog Pain is an Epidemic Ron Melzack developed the Neuromatrix theory and coined the word neurosignature. When our brain develops a pain neurosignature, a mass of neural networks in the brain create a pain output, that neurosignature divides into two pathways. One that produces the perception of pain and one that produces a corresponding motor response or holding pattern.
Here is a great example, taken from Dr. Lorimer Moseley from the University of South Australia:
Dr. Moseley was camping in the bush and walking to a lake when he felt a scratch on his ankle from what he believed to be a twig. He continued on his way but later became very ill and almost died from a poisonous snake bite. That scratch was not a twig it was a snake. Fast forward a few years, he again is in the bush and scratches the same ankle on a twig. He described the pain as excruciating only to find out it was a twig scratch and not another snake bite.What had happened after the original injury (snake bite), is that his brain created a neurosignature by processing the severity and danger of the snake bite on his ankle and stored that information for future reference. When he got scratched by the twig a few years later, his brain processed the sensation based on this stored information and created an excruciating pain response from this benign event (simple twig scratch).This example speaks to how our brain and nervous system decides if the body is in danger and a pain response is triggered based on how it perceives the information it receives.
The good news is that the brain is plastic. Maladaptive pain responses can be released, or unlearned and old patterns can be replaced with functional ones. This is what we teach our clients. This is the essence of The Method – its simple and successful.
