When Pain Lingers, What Should I Do?
December 1, 2016 8:17 pm
Pain. We all experience it. Sometimes, it’s an immediate response to an event such as the case with immediate tissue injury, trauma or emotional experience. Other times, it’s a shifting, changing, gradual sensation that changes over time in intensity and area. Sometimes pain goes away after a month or two, never to be heard from again as we return to our previous levels of functioning.
So, what about pain that doesn’t go away but instead lingers, seems to grow, expand and sometimes intensify? Does that mean that there are still tissues healing or perhaps still damage present? What if pain limits our function and keeps us from doing what we need and like to do each day? What if we start avoiding activities, become fearful of moving and stop participating in regular functions? Physiotherapists see this as deconditioning – loss of strength, balance and coordination and sometimes fear of movement. Sometimes, pain affects our ability to work and interact socially.
Persistent pain, commonly known as chronic pain, describes pain that lingers after typical tissue healing has occurred. Persistent pain is real, yet sometimes a tissue or “cause” can’t be found to blame for what we’re feeling. Persistent pain affects approximately 1 in 5 Albertans (Alberta Pain Strategy, 2015) and estimates suggest 1.5 billion people worldwide. Over the last 10-15 years there has been an explosion of research to support what we clinicians see with our patients. Long after tissues have healed and in the absence of any sinister MRI, X-ray or CT findings, many people struggle to ease their pain.
So, what do we do about persistent pain? Evidence continues to show that thoughts and movement are the important factors for changing how persistent pain affects our daily function. Retraining our brain and our movements so there isn’t a sense of danger is the key.
This translates to slowly rebuilding strength and function along with confidence in a graded, gradual and steady fashion in a variety of situations. As part of this regime, we need to ensure that we get adequate, restorative sleep, manage how we handle stress and work to feel safe in our bodies. Many people suffering persistent pain need a team of health care providers addressing the variables within thinking and movement and to assist in regaining health and functioning. Ask your Fifth Ave Physiotherapist with Fellowship in the Canadian Academy of Manual and Manipulative Physiotherapy for assistance and more information.
Diane Roylance PT, BSc (Zool), BScPT, FCAMPT, CGIMS
References and Resources:
- Explain Pain by David Butler and Lorimer Moseley. Noigroup Publications, 2003 (Updated version currently in press).
- The Explain Pain Handbook Protectometer by G. Lorimer Moseley and David Butler. Noigroup Publications, 2015.
- The Brain that Changes Itself by Norman Doidge. Penguin Books, 2007.
- Alberta Pain Strategy, Pain Society of Alberta 2015.
- The Canadian Pain Society Pain in Canada Fact Sheet (2016).