Intrinsic Physical Therapy

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Persistent Pain

Redefining Pain

When we hear the word “pain” we often think of something negative. We may even begin to feel fearful, anxious or a sense of dread.

But what if we were unable to feel pain?

At first, the thought of never feeling pain might sound pretty great, until we think about the reason for pain. Pain is a protective mechanism- it helps us survive. We now know there is a difference between acute pain and chronic pain. 

Pain occurs when your nerves activate an alarm response, which travels up your spinal cord and to your brain, and then your brain determines whether or not you feel pain. Say for instance you break your ankle – you want to know about it. You need to avoid making it worse and seek out treatment to help it get better. Acute pain does all of these things for us. Acute pain can last up to 3 months and in general lets us know when something is wrong. As the tissue heals, pain levels decrease, our nervous system returns to baseline and then our body knows that it is ok to resume activity. 

In chronic pain, we now know that the same response can occur as in acute pain, but the nervous system does not return to baseline. It stays elevated. We call this a hypersensitive nervous system and it can lead to a condition called central sensitization. When this occurs, the nerves are more sensitive to everything they sense such as movement, temperature, pressure and stress. This is why you may feel that your pain occurs with less and less activity. The neuropathways in the brain can become wired in this way and can lead to persistent pain symptoms. 

Pain is a complex behavior state that can have many factors influencing it and therefore treatment should be multi-faceted. Physical therapy can help you manage persistent pain by retraining your brain and calming your nervous system through interventions such as brain games, manual therapy and movement.

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