Earlier this summer we covered some of the ways pain and especially chronic pain works. Of course the question begs, “OK so…What do I do about it?”
To review, in chronic pain situations what can happen is the nervous system gets sensitized. An initial injury damages tissues, as a protective response, the brain sensitizes this area to guard it as it heals. In some people even as the tissue heals, the nervous system continues to stay sensitized or even becomes more sensitized. With this situation even normal movement can become painful reinforcing a situation of reducing function and continuing or increasing pain. So we have tissues that may be healed properly, and are perfectly safe to move, but because the nervous system is sensitized, pain continues to be produced.
Research has shown that a number of things can reduce the sensitivity of the nervous system. None of these are easy, and there are usually no quick fixes for chronic pain caused by a sensitized nervous system. Many people in this state have been there for months if not years. Many have had numerous medical opinions and failed treatments which can lead to fear and stress which also can sensitize the nervous system. It takes time and consistent effort but these following things have all been shown in research to reduce nervous system sensitization.
- Education: The first topic you have already started. Research has shown that learning about pain and understanding how it works can actually begin to reduce the fear and anxiety about it. This can start to turn down the system. Many people who have chronic pain have never been taught how pain works. And, they may have many misconceptions of how it works. This, along with multiple diagnoses and varying opinions on proper treatment, can lead to stress, fear, and anxiety, which all increase nervous system sensitivity. People have been given proper treatments of medication, exercise, manual therapies etc.., but because of poor understanding of pain, a comprehensive program is difficult to maintain. By understanding pain, people can see the logic behind treatment and can understand better what to do, why to do it, and how to do it. For more information on pain check out this page, http://ascentpt.wordpress.com/?s=pain+links for more detailed information, or seek out a therapist who understands therapeutic neuroscience education.
- Aerobic Exercise: Aerobic exercise is exercise that brings your heart rate up and is done steadily for an extended period, at least 20-30 minutes. Although if you have been in severe pain you may need to work up to this. Examples of aerobic exercise are walking, biking, swimming, or machines like an elliptical. Again research shows this is an effective way to ramp down the nervous system. Think how exercise can reduce mental or emotional stress.
- Graded movement/activity: This relates to aerobic exercise, but also incorporates other movements or household or work activities. Many people have seen their activity level drop significantly because of pain or fear of pain. A mistake they make is that they then attempt to jump back in to activity to vigorously after a long layoff, get a severe pain reaction, then avoid it. It is much more effective to start with a manageable level activity, whether it is a short walk, easy stretching, or limited household chore. When this is done without harm, the nervous system can accept it and slightly ramp down, and then you can steadily increase the level of activity. If the nervous system is turned up to 10 on a scale of 1 to 10 these activities will not drop it to 1 immediately, it will go to 9 then 8 then 7…We need to nudge it and tease it in the right direction.
- Relaxation/breathing: Deep breathing and relaxation techniques have also been shown to turn down the nervous system. This can take many forms such as learning and using diaphragmatic breathing, meditation, prayer, and yoga among other things. Taking time daily, or when pain is particularly strong to reset and relax the nervous system can be an effective way to move forward and calm your system.
These are 4 simple, although not always quick or easy responses, to calming a nervous system and gaining some control over pain. Many people get caught in a cycle of chasing answers that may not be there, fear and anxiety, and loss of hope and control. Living with pain on a daily basis is difficult and life altering. Finding ways to gain control of the pain can also be life altering in a positive way.