Managing Chronic Pain – by Dr Helen Frederikson (osteopath)

By Eliza Gleadell
October 26, 2023

Are you struggling with pain that just won’t go away? Perhaps you’ve been told that your imaging shows there’s nothing wrong even though it feels like there’s definitely something wrong? Maybe you’ve been through so many treatment providers but gotten nowhere? You may feel like no matter what you do your pain seems to come back to that same place over and over again and it may feel like the area is sensitized. Keep reading to discover the reasons why your pain could be lingering beyond normal healing time and what you could be doing to improve it.


What is Chronic Pain?

People injure themselves every day, it’s not uncommon. Following an injury the standard time for most people to heal from their pain is around 6 weeks, sometimes up to 12 weeks. If you have pain that persists longer than 12 weeks it is then termed chronic pain.

When you have an injury such as a whiplash to your neck or chronic headaches or a lifting injury to your back, a message travels from the injury site through the nervous system and up to our brain saying – help….do something about this! A message is then sent back down to the injury site to create a local response such as pain and muscle spasm. Our brain is the part that decides how our body will respond to an injury. Imagine it’s like a flame traveling up a fuse. It goes from the injury to the spinal cord, then up to the brain. The bigger the flame is, the more pain you will feel.

Our bodies are super clever and make certain hormones (predominantly adrenalin and endorphins) that act like buckets of water to the flames. Adrenalin is our fight or flight hormone that we produce during intense and stressful situations, like when we’re running from danger. Therefore having adrenalin pumping through our bodies all the time isn’t ideal. Endorphins, however, can be produced around the clock! Endorphins are produced by exercise and by doing activities that we enjoy and that bring us a sense of achievement. This could be as simple as catching up with friends, doing arts and crafts or even mowing the lawn. The more of these buckets of water we can throw on the flames, the less pain we feel.

Unfortunately, when we’ve been in pain for a long time we generally stop doing the things that bring us joy or a sense of achievement, and we no longer create all of those buckets of water we need to put out the fire. When we’re not making buckets of water we create a negative cycle where we become sad or worried about a flare up or angry that we can’t do the things we want to do because we end up in pain. As a response our bodies create other hormones such as cortisol which we will call buckets of petrol. These buckets of petrol fuel the flames and make our pain stronger. Over time, the more pain that is produced from general activities, the more our nervous system becomes sensitized to these stimuli, resulting in more flare ups and creating a localised tissue response at the initial injury site.


Managing Chronic Pain

There are ways in which ongoing pain can be improved! General manual therapy is fantastic for reducing the symptoms of a flare up, however, if your pain has been particularly persistent you may require further investigation and management into lifestyle factors to help get you out of the pain cycle. This might include looking at your sleep, activity, and stress levels.

Firstly, find activities that bring you lots of joy and that don’t flare up your pain. That way you’re creating lots of buckets of water but no buckets of petrol!

Sleep is also incredibly important for our ability to process pain and to heal. When we are tired we don’t cope as well mentally and physically with day to day stressors. Research suggests that when we sleep well, our pain levels drop 1-1.5 points out of 10!  To improve sleep decreasing stimulation before bed may be helpful. Watch less TV, dim lights, stay off our smartphones. As adults, sleep comes in 90 minutes cycles. If you prepare for sleep before the end of each cycle by winding down and getting in to bed then you may find it easier to fall asleep. If you tend to wake up and worry overnight then it might help you to write these things down and then go over them during the day. Having a consistent wake time will help set a rhythm for your day.

It may be beneficial to monitor your stress and activity levels. Stressful situations may increase pain leading to random spikes throughout the day. Making sure you’re doing activities that promote relaxation like having a nice hot bath or practicing mindfulness and meditation may help to improve your symptoms. Doing too much of a certain activity can also lead to pain so cutting back on these activities and then building them back up slowly is a great way to decrease the hypersensitisation. For example, if you are mowing the lawn for 20 mins and you start to feel pain at 15 minutes then it may help to reduce the time to 10 minute increments, gradually increasing the time every couple of days.

If any of this resonates with you and you would like to find out more about managing your persistent pain then get in contact with Helen or any of our team at The Osteo Clinic.

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