Managing Pain
Your pain is real, and once you have it, you want to rid yourself of it. This is understandable because pain is another layer in your ‘stress bottle’ and is unpleasant. http://bit.ly/TheStressBottle
But the unpleasantness of pain is the very thing that makes it so effective and an essential part of life.
The Benefits of Pain
You probably never thought that there could be any benefits to pain. Well, pain protects you, it alerts you to danger, often before you are injured or injured badly. It makes you move differently, think differently, and behave differently, which also makes it vital for survival.
Pain is the brain’s way of protecting body tissues; if it believes your body tissue is in danger (real or potential) it will generate to warn you and try to protect you from further harm. Likewise, anything that suggests your tissues are safe reduces the need for your brain to protect you by producing pain. These processes in your brain are super-fast, unconscious, and automatic.
Pain and the Brain
All pain experiences are normal and are an excellent, though unpleasant, response to what your brain judges to be a threatening situation. If problems do exist in your joints, muscles, ligaments, nerves, immune system, or anywhere else – it won’t hurt if your brain thinks you are safe. In the same way, even if no problems exist in your body tissues, nerves or immune system, you would experience pain if your brain believes you are in danger. This explains the many records of people who have undergone major surgery while hypnotised, without medical anaesthesia; the tissue is being damaged, yet they feel no pain because the brain is unaware. Conversely, people can experience pain without any tissue damage.
A really helpful video that explains how the brain responds to pain is below. This video highlights that our responses to pain are unconscious and automatic processes which we have no control over. It also illustrates that pain is mouldable i.e. if we feel safer, then the brain is less likely to produce pain: TEDxAdelaide - Lorimer Moseley - Why Things Hurt - YouTube
Therefore, the brain relies on context and cues to decide whether to protect you using pain. The context of the pain experience is critical and it is your brain that decides whether something hurts or not. In order to effectively deal with pain, it is important to identify the contextual cues, know more about how pain works, and use strategies that will increase the brain’s feeling of safety.
Central Sensitisation
Central sensitisation is a term used to describe when the nervous system becomes in a persistent state of high reactivity. Some patients experience this as constant pain because the nervous system has become hyper-sensitive and so the pain threshold is lower.
To understand this concept further, you can compare it to a car alarm system that triggers any time the wind blows; an overly sensitive nervous system can lead to false alarms, which means that you may experience pain at times when you haven’t necessarily been injured. Just as the faulty car alarm may be triggered by the wind, the nervous system can be triggered by normal sensations such as using muscles you have not used for a while, which are perceived as a threat.
The intensity of pain experienced is dependent upon the intensity of the “threat” signal, and can sometimes last even after the perceived threat has passed. This can contribute towards chronic pain and conditions such as fibromyalgia.
How to Manage Pain
Pain can affect our lives in many ways. Sometimes when we are struggling, pain can stop us from being in the present moment, and move us away from what truly matters. One of the first steps to managing pain is to understand what might be keeping you stuck, and this may relate to unpleasant physical sensations, unhelpful thoughts and unhelpful coping strategies .
See example below:
Essentially, pain management involves you dropping the struggle, and employing strategies to help support a willingness to allow for pain to be there. This may include engaging in activities that allow you to open up to the pain, instead of distracting away/ignoring it; to acknowledge that pain brings unhelpful thoughts such as “why won’t it go away” or “I wish I could get rid of it”; and to re-connect with matters. See example below:
Mindfulness exercises can help you to “open up” to the pain, and learn ways to become comfortable with the uncomfortable. You can access mindfulness exercises here http://bit.ly/ActandMindfulness. Additionally, the following strategy may help guide you to think about your triggers that exacerbate pain, and also what can help reduce it.
DIMs and SIMs
The brain relies upon context and cues to decide whether to protect you from pain. The brain weighs up ‘danger’ against ‘safety’. Anything that suggests your tissues need protecting, increases the level of pain and can be perceived as the “Danger In Me” (DIMs). Conversely, anything that suggests your tissues are safe, reduces the pain and can be perceived as the “Safety In Me” (SIMs). These processes are very quick, automatic and unconscious. Below represents a visual diagram with examples of DIMs and SIMs. They are categorised into 7 areas:
- Things you hear, see, smell, taste, touch
- Things you do
- Things you say
- Things you think and believe
- Places you go
- People in your life
- Things happening in your body
(image from https://www.noigroup.com/noijam/dim-sims/)
Take some time to have a think about what your DIMs and SIMs are.
There are also apps which can help you engage in mindfulness exercises and breathing techniques to help “sit with” pain and other difficult thoughts/feelings:
- Chill Panda
- Stress and Anxiety Companion
- Daily calm
- Mindfulness
- Headspace
- Smiling Mind
- Calm