What you need to know about pain

Pain is part of our alarm system, pain tells us something isn’t right, we’re not safe and we better pay attention and do something.  It is the strategy the body uses to make us stop and do something different. You may think of safety as a feeling or a judgement and it may be, but it is first a physiologic experience. The thoughts we have about whether we are safe or not and the feelings of safety are a result of our unconscious physical experience. Without any conscious thought, our autonomic nervous system alerts us when danger is near or threatened or perceived, and nothing gets our attention like intense pain.

We are wired to pay attention to pain. To understand pain we need to understand the working of the autonomic nervous system. Simply becoming startled will bring about an autonomic nervous system activation, an involuntary response.  This body response is to get us safe.  Our muscles tense so they are ready to fight or flee, our heart rate increases; our eyes widen to take in peripheral information; the core muscles, the psoas, tense so we can spring; adrenaline is released for strength; cortisol increases blood sugar for immediate use; digestion and long term immune responses are put on hold.  Access to our cortex, our thinking brain, is disconnected so no time will be wasted evaluating the situation. We can’t think, we must just act.   All these changes are really amazing and wonderful when we need them. But in our complex modern world we can have autonomic nervous system activation and we don’t respond by fleeing or fighting; we just keep on. When we don’t expend this energy/activation through a vigorous physical response, we’re left with its after effects, high heartrate, chemicals in our system, tense muscles, undigested food, depressed immune response, etc. Many of the so-called effects of stress are the residue of incomplete autonomic system response.

For some of us just the thought of a potential mistake or remembering a problem will trigger some of these autonomic changes but for people with challenging histories of abuse or neglect, the thought or other unnoticed stimulus may illicit a full blown FFF response.  A traumatized person’s autonomic nervous system has been trained to expect the worse and is always preparing for it.  Remember a quick unconscious response is best for survival, all of this happens without our awareness

Pain is controlled by the autonomic nervous system, when you practice relaxation, you decrease your pain by resetting your autonomic nervous system, which gets the message that you are safe and well. When relaxation doesn’t decrease your pain, your pain pattern is more entrenched, your nervous system isn’t convinced you’re safe, and will take more strategies to interrupt.

How does it all begin? An injury is most commonly accompanied by pain, the pain message is stop, in order to prevent further injury and heal.  But during the healing process we learn to continue to reinforce pain when we:

  • develop fear conditioning in the area. That anticipation of pain can make us tense and bring on pain. Muscle tension is often the result of fear (stress/negative anticipation), we tighten our muscles to prepare for the worst and that hurts.
  • develop compensation patterns by holding muscles that protect us in the short term but create chronic muscle tension and/or alignment problems over time. Muscle tension is an experience of pain that is not necessarily damaging but can become extremely painful when it becomes chronic.
  • learn to respond to certain stimulus with pain, because it has become closely paired with past pain. And we restrict our movement or activities to avoid to the pain which we have linked in both our minds and our neuromuscular pathways.

As surprising as it may seem all pain, learned pain, emotional pain and pain from injury travel the same nerve pathways. All pain is physiologically real even if it doesn’t involve an injury or damaged tissue, pain caused by emotions or habits is no less real.

You are getting by now that pain is complex; we don’t have “pure” pain or pain that is only a response to injury.  Pain involves suffering which increases our negative experience of pain.  Suffering is our emotional response to the pain (or our fear of pain).  In managing pain the best tools are understanding what pain is and isn’t. Identifying the contributors to pain that you have control over and making changes where you can.