Hey guys, Dr. Lell here writing you from the lovely Sellwood area of Portland, Oregon. Today I want to talk about long term pain and what it does to your body. There have been volumes written on the topic and this blog won’t hold a candle to the information out there, but it will be a nice place to begin for an introductory look. The experience of long-term pain does many other things to the body outside of being…well…painful.
Chronic Pain Makes Hurting Easier
Did you know your body has a threshold for pain? It’s determined by the brain and can change from day to day and moment to moment. Your brain decides what’s worth your attention. For example, if you’re walking along and you stub your toe, it could hurt. But if you’re running for your life and you stub your toe, you won’t likely feel it. The brain knows how to prioritize the threats around you. It’s the same thing as athletes finishing the last few seconds of the match or running those last few yards with a broken leg and not feeling a thing.
When one part of you hurts, you start to notice other things are hurting more. Things that wouldn’t normally bother you. This is because pain resets the threshold for the rest of your body. It’s like this. Imagine you live in an old house with shaky windows and creaky floors. The house has sounds that you don’t even notice anymore. Then one night, you get broken into. Now you’re on high alert. The next night, every sound from the wind to the cat jumping around gets your full and alert attention. Your alert threshold has been lowered. Same thing with chronic pain. (Full disclosure, that wasn’t an orginal analogy but I can’t remember where I learned it)
A nice way to balance out the threshold of pain is meditation, quality sleep, and plenty of exercise.
Chronic Pain Makes You Sick
Pain lasting longer than a few weeks increases your body’s cortisol levels. This is your body’s main stress hormone and tells your body to get in gear and go gO GO! The cells and structures of your immune system defend you from stuff every day. Think of it like a wall that’s constantly being beat on and shot at from the outside. And then, when it’s safe, someone goes out and repairs the wall for the next day’s attack. In a person with normal cortisol levels, this repair of the immune system wall happens regularly. When cortisol levels get higher and higher, the repair of your immune system gets put on hold. The wall isn’t getting patched up and it just gets weaker and weaker. Chronic pain sufferers are often sick with whatever is going around and at the change of each season.
There are great nutraceuticals for keeping cortisol levels in check that I prescribe to many of my high-stress patients, whether or not they suffer from chronic pain.
Chronic Pain Changes Your Brain
Chronic pain and acute pain have different causes, processes, and cofactors. Acute pain can be caused by an injury and complicated by things like the ergonomics of your job. Chronic pain can come from acute pain that never got resolved. Chronic pain can also be caused by things like your poor sleep and complicated by things like your terrible marriage. There are larger physiological and emotional influences in chronic pain. Some researchers at Northwestern University took people in acute pain and mapped their brain activity. As expected, the areas associated with pain were very active. Some of those people developed chronic pain and their brains were mapped again. The pain had done some rewiring in the brain. Now the areas with the most activity were the ones associated with emotions. This is why some chronic pain sufferers are worse off on bad days. Now the pain they experience is intimately tied with the emotions they think and feel.
Chronic pain is more than just pain that goes on for a long time. It has consequences for your entire body. Many people living with chronic pain have given up hope but but this condition (and it is a condition all unto itself) can be alleviated and helped. Chronic pain is a whole body problem and needs a whole body approach. The fundamentals to management are meditation, exercise, and quality sleep. The members of your management team should include a chiropractor versed in pain science, a massage therapist, an acupuncturist, and a counselor/psychologist. Treatments should include education, talk therapy, mindfulness training, and a nutritional/digestive assessment.
If you’ve been dealing with chronic pain, consider using the online scheduler to schedule a free consult to find out what can things can be done to alleviate this condition.
Until next time, remember to eat well and move often!
Yours in health,
Dr. Lell