What’s your Pain IQ?

1. Pain means you have physical injury or damage.

This is FALSE. Pain is simply the body’s way of telling us something is wrong. This can happen with injury but, oftentimes, overworked muscles or joints start to hurt as a way to tell us to take a break. There’s not an injury at that point but there is fatigue and dysfunctional movement as other parts of the body compensate for the painful area.

There’s also a nervous system condition called “allodynia” where even a light touch on the skin causes excruciating pain. In this case, the nervous system has become hypersensitive to what it perceives as threats, and it sends warning signals to the brain even if there’s no injury.

Chronic pain is a slightly different scenario, as it often begins with an injury. If there’s a long recovery time, the brain gets stuck in a pattern of sending pain signals. The injury might be gone, but the pain continues.

2. The body tells the brain where and how much pain to create

This is FALSE. The nervous system is what communicates with the brain. The central nervous system (CNS) includes the nerves in the brain and spinal cord. It is safely contained within the skull and vertebral canal of the spine. All of the other nerves in the body are part of the peripheral nervous system (PNS). Potential threats (like, stubbing a toe or cutting ourselves with a knife) are perceived by the nervous system and communicated to the brain via nerve endings. Then, the brain interprets the nerve-ending messages and decides whether or not to create pain.

The brain’s pain process is complicated. It not only takes into account what the nerve endings sent but also looks at memories, emotions, beliefs, and more. When you stub your toe, that instantaneous pain you felt took the brain through its decision-making process at a speed of less than 400 feet per second.

3. Chronic pain can cause physical changes to the brain.

This is TRUE. Our brains possess a high level of neuroplasticity, meaning an ability to change and adapt as a result of repeated behaviors.

When the brain processes pain signals for a long period of time, there are changes to the hippocampus, where learning and memory reside. In addition, there’s a reduction of gray matter, which processes information in several different areas of the brain. This means that chronic pain can negatively affect your memory, ability to reason, and concentration skills.

But, there’s good news! Neuroplasticity works in the other direction, too. Treating chronic pain can and will rebuild the neuropathways needed to help the body regain function without pain. Somatic pain therapy is a very effective way to do just that.

4. Mind-body techniques for pain management are not supported by research.

This is FALSE. Numerous scientific research and patient studies have proven that mind-body techniques like somatic pain therapy can help reduce or even eliminate chronic pain. Here are three examples:

  • 2017 – University of Utah study published in the Journal of General Internal Medicine: “After participating in a single, 15-minute session of certain mind-body therapies, patients reported an immediate decrease in pain levels similar to what one might expect from an opioid painkiller.”
  • 2015 – University of Pittsburgh School of Medicine: “A mind-body program for chronic LBP [lower back pain] improved short­-term function and long­-term current and most severe pain…”
  • 2007 – Sports medicine and pain management doctor David Schechter, MD: “We believe that a mind-­body approach is more effective and involves much less risk and expense than conventional approaches in appropriately diagnosed cases.”

5. No pain, no gain.

This is FALSE. This myth is common with bodybuilders, weekend athletes, and Americans in general. We push, push, and push some more. Then, our brains send pain to tell us that something is wrong and, for some reason, we want to argue the point.

It makes no sense that we could benefit by pushing through pain. Whether we’re exercising or simply moving our bodies throughout the day, our muscles are working and the muscle tissue needs time to regenerate. Exercise creates microscopic tears in the muscle tissue and, during rest, cells called fibroblasts repair it. This helps the tissue heal and grow, resulting in stronger and better functioning muscles.

This is another example of neuroplasticity. When we rest, our brains relearn that they, too, can rest and rejuvenate. This helps reduce both our physical and mental stress.

6. The longer pain goes on, the easier it becomes for the pain to return at a later time.

This is TRUE. Again, we’re back to the idea of neuroplasticity. A process called long-term potentiation means the more times the brain uses a neuropathway, the more familiar it becomes. The brain adapts to that pathway and can readily access it.

If your pain has been with you for a year or longer, you might notice yourself saying, “I don’t know what I did. It just started hurting again.” That’s because your brain is acting on autopilot, activating the pain pathway it knows the best.

In somatic pain therapy and other mindfulness techniques, you can learn to help your brain create new pathways that can operate without pain signals.

7. Expecting that we’ll feel pain can actually cause us to feel pain.

This is TRUE and it’s sometimes called the nocebo (opposite of placebo) effect. Basically, a nocebo effect is said to occur when our negative expectations regarding a treatment cause the treatment to have a more negative effect than it otherwise would have.

This is another example of the power of mind-body connection in our healing. As long as we expect to feel the pain, it will show up. For many of my clients who’ve been living with chronic pain, believing they can feel better is the most difficult part of their therapy. I often ask them to “suspend disbelief” and stay open to the possibility that their pain is no longer there. When they’re able to do that, they can notice how much better they feel and over time they can learn to trust that feeling.

8. Pain is a natural side effect of aging.

This is FALSE. Yes, some aches and pains are due to older joints and a lifetime of muscle activity. However, chronic pain isn’t correlated specifically to old age. Rather, it’s the result of illness or injury and that can happen at any age.

The National Institute of Health (NIH) studied the difference in chronic pain for young, middle-aged, and older adults. Perhaps surprisingly, the NIH study found that the prevalence rates for chronic pain DO vary with age, but it was the middle-aged group, not the oldest patients, that may be a high-risk group for chronic pain. The middle-aged group reported less satisfaction with life than the older group, perhaps demonstrating, once again, the power of mind-body connection. Attitude matters.

The report: Age and the experience of chronic pain: differences in health and quality of life among younger, middle-aged, and older adults. Tone Rustøen 1, Astrid Klopstad Wahl, Berit Rokne Hanestad, Anners Lerdal, Steven Paul, Christine Miaskowski

9. You can injure yourself further if you exercise when in pain.

This is FALSE. If you’re in pain, light to moderate exercise can improve blood and oxygen flow to your muscles which will help them relax and function with more ease. And, when the muscles can relax, the body will move more freely and pain can lessen.

If you’re living with chronic pain, you are also more inclined to suffer from anxiety and depression. Gentle exercise is known to boost your mood and can be a great help to you.

Your medical provider or pain therapist (like me) can help you choose which exercises are the most appropriate and healthy to keep you moving while your injury heals.

10. My (body part) hurts because I don’t stretch it enough.

This is FALSE. Sometimes we have pain because we’ve stretched too much.

The truth is, muscles can’t be forced into movements they aren’t able to perform. They are designed to be able to contract and lengthen and they are smart about how they do that. Muscles have a natural mechanism called stretch reflex that regulates the length of the muscle automatically by pulling it back when it goes farther than its comfortable limit.

If we try to pull it past its current ability, it’s going to reflex back even harder than it ordinarily would, and will tighten even more. The brain knows that the muscle has lost the lengthen part of its contract/lengthen functionality, perceives this as a threat (something is wrong), and sends pain signals.

That’s it! How did you do?

My first hope for you is that you don’t have pain. But, if you do, I hope this quiz helped you better understand some of the how/what/why of it.

I encourage you to make an appointment with me for a virtual or in-person session. Together, we can explore how somatic pain therapy can create new neuro-pathways in your brain, reduce your pain and improve your overall quality of life. Schedule your appointment now.