When pain strikes unexpectedly it can knock you off your feet, we all experience it differently and it has never been explained satisfactorily by medics or poets.
During their initial examination I ask new patients to try to describe their pain – I even have a list of suggested words approved by medical researchers: is your pain burning, aching, gnawing, sharp, throbbing, cramping, exhausting, punishing, etcetera? Medics term pain ‘nociception’, literally the sensing of noxious feeling, but no words can really capture your unique physical, mental and emotional experience of pain.
Short term pain is called acute pain (less than 2 weeks duration); long term, continuous pain is called chronic pain (greater than 6 weeks duration) and pain that comes and goes is called recurrent or intermittent. All pain is part of your innate warning system that you have a problem. The more we learn about pain the more we have to adopt a holistic view that the ‘problem’ has emotional (e.g fear) and psychological (e.g stress) elements as well as purely mechanical aspects. This is particularly the case in chronic pain where you may experience pain signals that are out of proportion or no longer needed because you are well aware that you have a back problem after three months of constant aching.
Our emotional as well as physical state affects how we feel pain.
Have you ever cut yourself without noticing and not felt any pain until you saw the blood? Or perhaps you’ve been hurt in a situation where you needed to focus your attention on escape or survival and you didn’t feel any pain until the danger had passed? Perhaps you’ve felt particularly down and an injury or headache that you could usually put up with seemed overwhelming? Worry about time off work, isolation from missed social opportunities and a feeling of dread that the pain will never end can all contribute to a vicious circle of negative emotion, pain and then more negative emotion. Such incidents are all evidence that your emotional state has a great deal to do with how you experience pain.
Pain is complicated, huh? Although we still have a lot to learn about pain, we do understand how pain signals normally travel from the site of damage through pain receptors and then nerves, up through the spinal cord and then into the brain where they release chemical messages. It’s not so much like a car travelling along a road as a relay race where the baton (the pain signal) is passed from receptor to nerve to nerve to neuron (brain cells). If you think about all those different points of contact there is a lot of scope for mistakes, exaggeration and misdirection, as in the children’s game of Chinese Whispers, and this can lead to chronic pain or referred pain.
The Approaches + Evidence
Traditional drug based approaches to understanding and relieving pain have focused on blocking the chemical signals that tell your brain that you have tissue damage. Talk about shooting the messenger! Although drugs have their uses, long term use of analgesics and anti inflammatories can cause more pain than relief in the long run, creating health problems like digestive disorders and liver damage.
Modern holistic spinal health care practitioners like myself take account of you as a whole person: you are not just a walk in knee or back injury or case of persistent headaches. As a chiropractically trained Osteomyologist, I aim to find out and relieve the cause of your problem (via the nervous system) as well as offering drug free, effective pain relief. It is also my duty to recommend therapeutic and rehabilitative exercises, provide nutritional, dietary and lifestyle counselling—all of which are important components in chronic pain management – and to work closely with other members of your health care team.
A significant amount of evidence shows that the use of specific spinal adjustments applied for problems such as acute and chronic lower back pain, neck pain, headaches and many other neuromusculoskeletal conditions can be more effective than treatment using traditional medical care. In fact, a 2003 study published in the medical journal Spine found that manual manipulation provides better short term relief of chronic spinal pain than does a variety of medications. A 2005 study in the Journal of Manipulative and Physiological Therapeutics comparing a chiropractic adjustment with traditional medical care alone concluded that chiropractic adjustments produced better outcomes for chronic pain and a 2001 study by Duke University that found chiropractic manipulation appropriate for both tension type headaches and cervicogenic headaches.
And your secret pain relieving weapon? Well, that is your own determination that you will not allow pain to take over your life.