What is Chronic Pain?
Article by Alex Clarke
Recent research has helped to shed more light on the changes that occur in your body with chronic pain.
What is Normal ‘Protective’ Pain?
Normally pain is good. It informs you about potential or actual damage to your body’s tissues. Nociceptor nerve cells in the tissues of your body, react to strong stimuli such as pressure, heat, cold or chemicals.
These nociceptors send a message to the spinal cord, which then forward another message up to the brain. Your brain then processes these messages and produces a coordinated response to escape whatever is causing the tissue damage.
What is ‘Pathological’ Pain?
Research has shown that changes occur in your body at all levels of pain processing. These changes include:
Changes at the Injury Site
At the site of the injury, your peripheral nerve becomes much more easily excitable. This means that it takes far less of a stimulus to cause it fire off. In some cases, even a gentle brush against the skin is enough to fire off the pain pathway.
Unfortunately it is not just the damaged nerves that become more excitable, but also the neighbouring nerves, which means even further amplification of the nerve messages. Some nerves can also start firing off spontaneously, which means that they do not need a stimulus to fire off.
Changes in your Spinal Cord
In the dorsal horn of the spinal cord, changes occur in some of the cells that receive the nociceptor messages. These changes lead to greater sensitivity to the spontaneous nociceptor messages mentioned previously. Changes can also occur in some cells that leads to a ‘memory’ developing between two cells, which leads to an amplified response in the neighbouring cell.
Changes in your Brain
Usually, your brain can decrease the level of pain you experience through releasing natural opioid hormones. When you suffer chronic pain, changes occur in the midbrain which actually increase the nociceptive messages. This means you’ll perceive even more pain.
Chronic pain messages stimulate parts of the brain involved in emotion, fear and feelings. This may help explain why conditions such as depression, sleep disorders and pain catastrophising are linked in with chronic pain.
We also know that chronic pain leads to atrophy or ‘shrinking’ of parts of the cortex and midbrain. Brain-stimulating activities may help to limit this ageing.
Do You Need More Information about Chronic Pain?
If you need more information about your pain or how to best manage your chronic pain, please consult the advice of your physiotherapist. Your physiotherapist is an expert at helping you to understand and reverse the changes that occur with chronic pain.
FAQs about Pain
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