All About Pain (part4)

Using the Central Nervous System to Your Advantage

As we’ve discussed, the nervous system is an amazing and convoluted structure that’s responsible for how we interact with everything around us. We can actually use this interplay to our advantage.

We know that when chronic pain is present, it affects the nervous system in myriad ways. For instance, those with chronic pain experience:

  • Decreased Two-Point Discrimination – This is a skin sensation test that measures a person’s ability to discern whether there are two distinct points touching the skin vs. one point. When a person is in chronic pain, they have a lessened ability to distinguish this accurately.
  • Impaired Proprioception – This is the awareness of the relative position of your body in space, which is important for movement, balance, and coordination. Those suffering from chronic pain often have decreased proprioception as well.
  • Sensitization – This is an astonishingly complex topic that fills entire courses and textbooks, of which two of the most readable and entertaining researchers are Lorimer Mosely and David Butler. Rather than adding another dozen pages to this post trying to work through this deep subject, we can simply state that sensitization means that pain begets more pain. In long standing pain issues, the body/brain is made more sensitive to recurrences based on sensory inputs that might otherwise be ignored if there wasn’t a previous pain response. Pain becomes like a particularly bad habit, frustratingly hard to get rid of.

With these concepts in mind, we can begin to understand how to use these to break free from the pain cycle.

If your body sensations and proprioception are affected by pain, it stands to reason that working on body awareness and proprioception can affect your pain. Spend time on a variety of movements that provide different stimuli and influences on your body sensations and you’ll induce changes in pain perception.

Our Vitamin course is designed to introduce your body to movements it likely is not used to. Challenging it in this way can drastically improve your sense of body awareness, and specifically, the many different ways your body moves in space. Research shows this can decrease ongoing pain.

Get a taste of how unique movements can impact your body with our free Movement mini-course

Likewise with sensitization. If pain begets pain, you need to “convince” your body to lose its memory of pain.

There is a great post by Todd Hargrove on sending “good news” to your brain about how your body is doing, and he argues that you should seek to do this in every training session.

After an injury, there is invariably a period of very limited movement. In this case, even the simplest rehab exercises can have such a profound impact on acute pain. I’ve seen people come into the clinic barely able to move and with some gentle handling and exercise, they walk out feeling significantly better.

And the same can happen with more chronic issues.

The more you can replace poor memories of painful experiences with new memories of the “good news” as Todd calls it, the better. Part of this is doing what feels “good” and avoiding what feels “bad.”

Some years ago there was a big push for classifications of conditions to better affect treatment, and out of this came the concepts of flexion (forward bending) or extension (backward bending) intolerance. So that instead of specific diagnoses we now look at situational factors that can aggravate your issues.

Activities such as being slumped at the steering wheel or at the computer provoke back problems in some, while standing for long periods and reaching up bother others. It’s a very apparent and simple thing but recognizing exacerbating activities and limiting their duration and frequency helps quite a bit in managing symptoms.

My Own Experiences Dealing With Pain

In addition to my experience as a physical therapist treating patients in pain, I’ve also been “on the other side of pain” so to speak.

I’ve had mid and low back pain since I was a teenager, and as my young co-workers remind me quite often, I’m old now. Thankfully it’s managed well with exercise and understanding of the primary aggravating situations.

I’ve had a lot of different treatment interventions over the years, from rolfing to spinal manipulation, and osteopathic technique to dry needles.

And while I had very good benefit, especially in the acute periods following an exacerbation, the treatments didn’t “cure” my condition, but rather allowed me a window of opportunity where the pain was reduced enough to get back to the flexibility, strength, and motor control exercises that mitigate the pain.

  • Improving motor control can help pain conditions for the reasons we’ve talked about above, with the practice of bettering sensation discrimination and body awareness.
  • Working on your flexibility can help, not necessarily because of structural changes, but more likely because of improving your ease of motion and replacing the memories of pain and stiffness with amended experiences.
  • And when we talk about strengthening for pain control, it’s not because you are building up an “armor” as a protection from insult, but more often it is for the sensation of stability, to keep all the sensitized structures feeling secure and stable.

pain part 4

If I were forced to summarize the best approach to pain management in one sentence it would be as follows:

Improving your body awareness and tolerance in different movements and modifying your habits as needed, especially those that generate pain, is the key to long lasting change.

You CAN Overcome Your Pain

I’ve had the opportunity to treat many patients over the years, and have many examples of when this approach has worked.

  • One patient came to me with low back pain that had been going on for years. After one treatment with me, she told me she had immediate pain relief that lasted several days.
  • Another patient had daily headaches for 20 years. After one session and teaching her one specific exercise, she’s had lasting relief from her headaches.

I don’t share these to boast of my “magic” techniques, but instead as an illustration of how pain cannot be simply related to tissue damage or structural issues. Otherwise, how could they be affected by one session after years of trouble? It isn’t that simple at all.

There was some very complex interplay between our expectations, education, and physical intervention, and the particular patient/therapist interdynamics that led to the result.

And I would be lying if I said I knew exactly what. Be wary of anyone that says they for know for sure.

The best ways to decrease and prevent pain issues are to work on them gently and progressively, increasing your strength and flexibility in all motions, by exploring your active movement in new and creative ways, and understanding that pain doesn’t necessarily mean damage from one causative factor.

Pain is a complicated issue and anybody selling you the “one secret way” to deal with it is either deluded or predatory.

Address the underlying issues that are responsible for many pain conditions, so you can stabilize your body, move with ease, and use the relationship between pain and the nervous system to your advantage.

Improve Your Condition

Build strength, flexibility, and control through locomotive exercises and targeted mobility work, so you can move the way you want to for a lifetime.

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Hello Health Group does not provide medical advice, diagnosis or treatment.

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Morteza Tafakory Sports Physician Expert

Morteza Tafakory studied physiotherapy at the University of Applied Sciences in Utrecht, Holland. During the time, he has come to understand the value of this discipline but also the shortcomings of this field of medicine.

For his whole life, he has been active in various sports and, as a result, he suffered some serious injuries. At the time he went into a physical therapy treatment program, he noticed the imperfections of a singular therapy form. The common tunnel vision often leads to treatments that must be performed according to specific protocols.

Because each person is unique, Morteza Tafakory does not believe in an approach that forces a therapist to remain within set frameworks. In his experience, physiotherapy is just one piece of the complex puzzle within the path of recovery. For that reason, he has gone on vast research to expand his toolbox as a therapist. Morteza Tafakory ended up with a variety of disciplines that complement each other, allowing him to offer a more thorough method of treatment. Through these specializations, he has developed his own approach.

Since a therapist never stops learning, Morteza Tafakory has already been enjoying this actively for the last 4 years, including Mylogenics ©, PHP © T.O.P. Trainer © A & B of the Overload Principle ©, Kinesiotaping, Sporttaping and I.M.T ©. He also keeps updated on the latest developments in the field of nutrition and dietetics.

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