Health and Fitness Number One Misunderstanding about Pain – Why It’s So Important 20 December 2018 Studio Pilates Why does the topic of pain have so much varied, and sometimes conflicting, information? Why is pain such a severely debilitating and prolonged problem for some, with a huge variation of opinions on what to do about it? Might this be why pain and injuries are a huge challenge for so many people? The number one misunderstanding about pain: That pain is a feeling, in the body. There is growing body of neuroscience and physiotherapy research that is making it very clear that this isn’t the case. This research has clearly shown that there are no ‘pain receptors’, no ‘pain signals’ from the tissues, no tissues ‘feel’ pain and there is no pain ‘in’ any body part. What does the latest research explain? Pain is actually created by the brain to protect you from harm, or potential harm. So what is actually going on for the brain to create pain? We know that nerves carry impulses/signals, from the body’s tissues that tell the brain about the state of the tissues. Information such as excessive stretch, excessive strain, over-compression, tearing, bleeding, swelling etc. is transmitted to the brain indicating an ‘unhappy’ state. This all happens in our subconscious. This newest way of thinking is that once the brain receives these signals then the subconscious brain decides on the best approach to protect the body. For some, the brain perceives these signals beyond a threshold and ‘bad enough’, then one of the brain’s protective reactions is to create the experience of pain and/or symptoms and make us conscious of needing to avoid damage. ie ‘STOP DOING WHAT YOU’RE DOING!’ Without this protective response, we would be much more likely to do more severe damage to ourselves, and for this reason, pain is a very successful protective mechanism. Let’s put this in context – what are some of the body’s other protective mechanisms? What happens when we have a lack of oxygen to the brain – we faint, it helps us survive. What happens when fluid goes into our lungs – we cough, it helps us survive. What happens when we drink too much (let’s think of the more serious consequences, not regretful ones!) – we are sick or we pass out, it helps us survive. This protective response can be very different in different people, even with the same ‘unhappy’ signals. Experience tells us that our individual brains are so different they can choose to produce a protective reaction, such as the type and location of the pain, that is individual to each of us. Think of the example of a professional runner: what would happen if the brain decides to create pain ‘in’ the shoulder? Chances are that runner wouldn’t stop and would just keep running! Now, what if the brain decided to create pain ‘in’ the hamstring? There is a lot better chance that it would be a good reason for the runner to stop, and do something about it! On the other hand, if the brain perceives these signals are under the threshold and ‘not bad enough’ then we remain completely unaware of any problem. This whole process occurs at a subconscious level – and this happens every day to all tissues in our body as a natural process The brain decides this low-level signal is not significant enough to create a warning (thankfully). Why is this an important differentiation? This differentiation allows us to understand what is required to resolve pain most quickly. Imagine the scenario of a car that is malfunctioning with a bright engine warning light on the dash. Is it sensible to think that we can fix the problem by doing something to the warning light itself? Or would it be more sensible to acknowledge the warning light and then check out every possible fault that could be causing a problem to the car’s engine, thus causing the warning light to be on? Recent studies teach us that pain is the brain’s equivalent of a dashboard warning light. This warning light analogy is a simplification because the body’s the warning light, ie pain and symptoms can be created by the brain, and present ‘in’ any part of the body for any problem anywhere in the body. For example, it may be that when you hit your thumb with a hammer, the warning signal produced by the brain creates an experience like pain ‘in’ the thumb – and usually, this is a very successful protective mechanism that results in moving the thumb out of its dangerous position to prevent further damage. Or it may be that injury occurs in the spine and the warning signal produced by the brain creates an experience like the pain is ‘in’ a limb (or vice versa) – and this is usually similarly successful in alerting us to avoid behaviours that add more strain to the damaged area. Everyone is an individual – thus variations of protective mechanisms and attempts to avoid more damage are possible. So does this mean that pain isn’t important? This way of thinking does not lessen the significance of pain. On the contrary, it actually validates how important pain is as a warning signal. Pain is a very important indicator for us to pay attention and change what we are doing to protect us from harm. The brain is very smart and at least one step ahead of our consciousness. This is fundamentally a good thing, because if we relied on our conscious awareness to avoid danger we would not do as well at protecting ourselves. For a start, our conscious awareness is too slow and distractible to respond effectively; and secondly, it would be too easy to consciously ‘override’ the warning by continuing our preferred activity despite the damage until it’s too late. How does this understanding help solve pain? Let’s go back to the example of the faulty car and the dashboard warning light. When looking for a practitioner to solve your problem, and you going to look for the practitioner that ‘fixes your warning light’ or the one that assesses all the possible reasons for why that warning light is on in the first place – and fixes it? About the Author – Dan Johnson is a Director and Physiotherapist at Baroona Physio, Auchenflower. Dan has been a Ridgway Method Practitioner for 10 years, meaning that he, of course, solves for the main cause, as opposed to ‘fixing the warning light!’ To this day, he still finds it amazing that even long-standing issues can be solved in as little as three days, and at most two weeks, by using this approach. This is an edited version of an article, originally authored by Michael Ridgway.