Ian Cleary

Understanding chronic pain is an important step in beating it. This page gives a brief over view of the current understanding of Pain.

The body

We have millions of tiny sensors in and around our bodies. They send important information to the brain about what is going on in us and around us. They detect light and movement (eyes) sound and vibration, (ears) as well as using cells on our skin and internal organs to detect changes in temperature, chemical changes, if our bellies need topping up, with food or water. All this information is delivered via the spinal cord to the brain. The brain then makes sense of this massive amount of information instantly and constantly and decides how to respond. It’s a big job but our brains are up to it. The brain might decide to respond in one instance by changing the chemical levels in our blood stream, or direct white blood cells to a cut, redirect energy from one system to another, keep us awake, to tell our muscles to pull back, or move, to shut our eyes, produce saliva, to tighten muscles, to get the heart to pump more blood, or to breath faster.

The proper communication between the messages going to the brain and the brain’s response keeps us safe and life going on normally.

Two things can go wrong in this ‘communication process’. The incoming messages can be inaccurate or the brain can respond in a way that is not useful for the circumstance. Or both.

Most of the work I do, regardless of the conditions, can be seen in these terms. The body and brain has learnt to respond in ways that don’t suit the circumstance. A hyper-sensiive nervous system sending exaggerated messages to the brain or the brain The response is often a normal healthy response (pain, inflammation, tightness, racing heart, tiredness) but not in that circumstance. This will be a theme across many of the conditions I work with.

So back to Pain and the incoming messages.

Even though we have receptors for touch, temperature, pressure, it often surprises people to learn that we don’t have ‘pain receptors’. We do however have receptors in the skin and internal organs called no-ciceptors. (pronounced no-see-ceptors) They detect tissue damage (or potential tissue damage) and send that message to the brain as an electric impulse. There is no judgement to whether it is good or bad, there is no emotion or feeling and it is not pain. It is just an electronic message of damage or potential damage.

We are constantly experiencing tissue damage. Just being in sunlight is damaging tissues. If we lift something there will be micro-tearing in muscles. This is normal but the message still gets sent ‘upstairs’ to the control room to decide on.

If the electronic message is weak, it won’t even make it to the brain.

If the message is strong enough it is able to jump the little gaps in our nerves called synaptic gaps and continue to the brain. The brain then can safely assume that the message getting through is a strong message because it has made it through those gaps. It is sill not pain, just a message.

In the Brain

The brain then has to make a decision about the electronic message and the nature of the damage or threat of damage. It has to make a decision on – Is this something I need to pay attention to?

This is where it gets interesting. The brain takes into account what else is happening – using other incoming messages (a cracking sound), our environment (I am on a trampoline), other times in the past when this message came through (I broke my arm when I was young on a trampoline), our beliefs about what this might mean (If this is a broken bone I could be out of work and loose my job) and then decides if it needs to pay attention or not.

This is how the pain experience is unique to each person.

If we do need to pay attention, the brain creates pain.

If it isn’t something it needs to pay attention to it blocks any similar incoming electronic messages. So the brain taps into incredibly fast and powerful chemicals and sends them down the spinal cord to stop incoming messages and while turning off pain.

So the brain plays an integral role in all pain experience. The intensity, the sensation, the duration is controlled by the brain – whether it is a ruptured organ or a broken leg. We now know that activity in the nociceptors (the receptors on our skin and organs) isn’t an indicator of pain levels. The level of damage doesn’t determine the amount of pain. It is the action of the brain that determines pain.

Chronic Pain

So in Chronic Pain, the brain is still deciding to pay attention to the site and turn on pain, (or send inflammatory chemicals, produce swelling, direct histamines, create an immune response etc) even though there is no longer tissue damage or risk of tissue damage. The pain is the same as when the tissue was damaged. It’s the lingering pain that never really went away or fully improved.

After long-term activation of the nociceptors and pathways to the brain, there can be change to the sensitivity of the nerves. In the past, only strong electronic messages could jump the gaps in the nerves, but after repeated activation, weaker messages begin to be able to jump the gap. The nerves are more sensitive and are activated by weaker messages. When this happens (Central Sensitization) the brain mistakenly assumes that the weak messages of damage are in fact strong messages of damage, and keep the pain going. Further keeping the system in a state of hyper-sensitivity. In this case a person is stuck in a pain cycle.

So the pain is real but the problem is no longer at the site of injury or where we feel the pain. It has more to do with an overly sensitive nervous system and the brain’s response. SEE difference between acute and chronic pain.

Pain drugs tend to try to block or lessen the messages being sent along the nervous system to the brain. But the brain can still decide to turn on the pain without any incoming messages from the body. Why? Because when the brain takes into account all the other factors when deciding if this is something we should pay attention to.  So even when there are no messages running from the painful site to the brain (thanks to powerful drugs for example or because all healing has occurred) the brain can still turn on pain – sometimes running on nothing more than past experience. It is like it says – Ok so I am not getting any messages saying there is a problem down there, but I know in the past in this type of situation there was a problem so to be sure I will turn on pain.

Other factors that will keep the brain turning on are – anxiety (what if it is soemthing serious) or beliefs (if I over do it I could cause serious damage).

So sometimes not even incredibly powerful pain killers can solve the problem.

By this stage it is generally not a single issue so the Lightning Process addresses many elements that are now influencing the pain experience.

The Lightning Process looks to address this problem in two ways – change how the brain is responding to the incoming messages and desensitize or calm the nervous system (turning off the PER) so that the messages are more accurate.

The Lightning Process looks at what we can do about this miscommunication between the brain and the body and through focused practice, we can retrain the brain and the body to improve.

Want to find out more?

Hopefully this information should be exciting as it shows us the role that we can play in regaining control over Chronic Pain. This new information is as fascinating as it is important.

But it is important to understand the difference between Acute Pain and Chronic Pain. Please read on to understand more about Chronic Pain vs Acute Pain

 

 

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