As described in our previous post pain is an alarm system in the indicates that the body or different tissues are being over stressed. The pain alarm system runs on a small electrical signal through the nervous system. As stress in tissues increase the electrical signal rises until it reaches a threshold. Once the threshold reached, a signal is sent to the brain and an output is produced by the brain, typically eliciting pain.
In most individuals as the stress or strain of a tissue is reduces, the electrical signal slowly lowers in the nervous system. Unfortunately, in 1 out of 4 individuals the resting electrical signal does not lower and stays at a higher level. When we look at the chart below we see the normal resting level versus someone with persistent pain. With an amplified electrical level, the body has less tolerance to movement activity and positioning prior to pain being experienced. So in essence individuals with an amped up electrical system cannot tolerate normal movements or activities without pain.
When pain is induced with very little activity, increase fear and anxiety are induced prior to or during performance of said activity. This is extremely frustrating for individuals because they feel that two things are occurring. One the body part still has not healed, and two the activity is causing further damage to the area. Because of these negative thought patterns, continual avoidance of the activity occurs, or continued pain is experience while perform such activity.
So how do we fix this pain paradox, or pain cycle. Number one is knowledge. Educating individuals that pain does not equal harm can lower fear and anxiety. Fear and anxiety increase the resting level of the nervous system thus creating less movement tolerance. Number two is pain modulation. Perform a similar activity that does not elicit the same pain response but provide similar movement patterns. This tricks the brain in changing its output as the brain experiences similar activities without pain, it responds by turning down the alarm. Number three is graded exposure. Performing the activity with lower intensity or duration, and over time systematically increasing intensity and duration as the body accommodates to its new threshold.
The take away from this post. 25% of individuals have persistent pain secondary to raised electrical signals in their nervous system, not tissue damage. The fix for this pain paradox, education, pain modulation through similar or alternate activities and graded exercise or activity exposure.