Why do I have persistent pain?

Persistent pain is pain that has been present more than 3 months.

There are many factors that can affect pain such as ineffective sleep patterns, individual beliefs, beliefs of friends and family, anxiety, fears, worries.

Sometimes we can have an injury and we have a cascade of events. For example, if I rolled my ankle, there will be a chemical reaction stimulating the nociceptors which detect this pain. My ankle will hurt and be sensitive, this tells me to protect the area. The pain messages are sent to the brain by the nervous system. This is the most common type of pain. This allows me to protect my ankle and allow it to heal. As my ankle structures that were injured heal normally the sensitivity around the ankle should settle down.

Sometimes this does not happen and we can still have increased sensitivity months later. Most structures like broken bones, tendon injuries, ligament injuries and back injuries heal long before six months. So why does it still hurt? We are all individuals therefore we are all very complex and individual. If we are stressed, anxious, worried, have googled things on the internet it can affect pain.

If our beliefs are incorrect, we have been told by relatives or googled causes we can create maladaptive pain behaviours. This can cause a change in output i.e we change the way we move, we become more anxious and worried, and we start to re-scrutinise why this is happening. We are now in a negative cycle that can feed in to persistent pain.

Previous experiences are also crucial. If we have previously had a back injury that was painful or lasted a while, we will remember the experiences even if we do not realise it.

My favorite way of remembering this is a story by an Australian Physiotherapist.

' I was walking down a path in Australia, very bushy and overgrown. I walked past a sharp bush and felt a scratch, didn't think anything of it, and kept walking. 20 minutes later I was lying on the floor in agony...

He ended up in intensive care and it turns out he was bitten by a snake!!!

12 months later he was walking in the bush again (crazy Australians) and brushed past a branch. He felt a scratch and immediately fell to the floor in AGONY. Was he bitten by a snake again?.....

No. In our brain we store emotional cues, have you ever come across a smell that has bought back memories? He walked past a bush and felt a scratch on his leg. His brain, sub-consciously recalled previously negative experiences associated with pain from a scratch whilst out in the bush. The threat levels were straight away elevated and the pain response was severe. This caused his behaviour which was to roll on the floor in agony. BUT... it was just a scratch and no snake bite.

The moral of the story... hurt does not equal harm. We are all unique and pain can be complex. 80-90% of the population experience low back pain, 20-40% experience persistent low back pain.

At North Devon and Cornwall Physiotherapy we can assist with diagnosis and management of acute and persistent pain. We can provide education, advice on sleep hygiene, pacing/spacing, advice on exercise and movement and long term management.

We cover Barnstaple, Bideford, Holsworthy, Bude, Launceston, Bodmin and St Austell.

Make an enquiry to find out more.