Pain and Sensitivity
As we pointed out in our previous blogs, for some people, their pain is (or may be) related to injured or damaged tissue. But for others, the pain may be more to do with their pain alarm system becoming over-protective over time. In this case, often the nervous system has become over-sensitive over time. While being stuck in a cycle of pain is never much fun, the good news is that if the nervous system can become sensitised, it can also become de-sensitised.
So what is sensitising you?
Often, we find that there’s more than one thing that is sensitising you.
Have a look at the image below, courtesy of renowned pain researchers Lorimer Moseley and David Butler. Once the bilby lands in the water the bathtub is going to overflow because it’s already close to full. But once the bathtub overflows, it won’t be just the bilby’s fault, there’s other animals taking up space in the bath too.
This is a great analogy for becoming sensitised. There’s a number of things that combined together, could fill your bath and cause it to overflow, or in your case, cause your pain alarm system to become over-sensitive, leading to pain. Some of these factors are:
Lifestyle factors:
Sleep – this is so important in pain management. Studies have shown that pain and poor sleep are not a good mix. Poor quantity and quality of sleep can lead to increased pain levels. In a future blog, we’ll look at some strategies for improving sleep to help with your pain.
Diet – while it’s not in the scope of physiotherapists to prescribe diets, we know that a poor quality diet doesn’t provide the body with the right nutrients to recover well.
Physical activity – pain often leads us to doing less and becoming more sedentary. Physical activity is important for recovery from pain, partly because it helps to release certain hormones which are natural pain relievers.
General Health issues:
Research tells us that those with other general health conditions will likely take longer to recover from pain episodes. Poor general health is a big sensitiser of the nervous system. Some of these conditions include: heart disease, depression and diabetes.
Cognitive factors:
Coping strategies – some people are naturally better than others at coping with crises in life. Some people have mental or emotional strategies to manage life with their pain, while for others, pain seems to control their life. There are strategies which you can learn to help manage your pain better.
Beliefs regarding pain – those with negative pain beliefs, such as believing that they will never get better, or that their pain will only continue to get worse as they get older, or that there must be significant tissue damage will likely be more sensitised.
Stress:
General life stress can be a very important factor in our pain experience, causing our brain to determine that we must need more protection.
Tissue injury:
While it’s often not the only factor which leads to pain, tissue injury will often play a role in persistent pain.
This is not an exhaustive list of factors which can sensitise you, but it summarises some of the most common factors that we tend to come across. While some of these factors we have no control over, many of them we do (or are at least able to manage a little better). Going back to the bilby analogy, the better we manage these sensitising factors, the less full the bath will be, and you will start to de-sensitise.
How would you rate yourself on these contributing factors?