Pain is an unpleasant sensory experience from actual or potential damage. Chronic pain is not about damage, it is a threat calculation by the brain.
A man named Michael is diagnosed with chronic pain after a series of serious car accidents eight years ago. He needed surgery for degeneration of spine and herniated discs of spine. Now he has developed chronic back pain and rates his pain a seven of ten most days.
Michaels pain is not about damage from eight years ago. Medical professionals agree that after six to twelve months all body tissues are healed as well as they ever will be.
But Michael still has severe pain every day. He takes medicine to control the pain. He avoids activities he used to do. Michael really has severe chronic pain.
The good new is Michael is not broken! Chronic pain does not equal damage. Michaels pain after eight years is driven by nervous system “noise”. It is important to understand that Michaels pain is not creating new damage, its because he is getting too much noise from his nervous system.
When pain stops serving its purpose and becomes chronic, it begins “protecting” from things that don’t cause damage. His brain is getting nervous system noise signaling pain to things that are not a threat.
Consider a pain sensation in Michaels back. His body adjusted the volume of noise of the up to eleven different times in the brain and spinal cord before registering in the brain. In chronic pain the noise is being turned up and up before getting to the brain, giving a false signal.
The theory makes sense, but is there any hard science behind this?
In a 2013 research study people were given the exact same pain signal from heat for 30 seconds then asked to rate the pain. Pain ratings ranged from 1.05 to 8 out of 10 to the exact same stimulus! Persons with chronic pain rated the highest.
Our chronic pain rehabilitation works to turns down the nervous system noise back to normal levels. We have discussed stress management and sleep hygiene to control the nervous system noise. In the next module we will talk about other ways.