Chronic Pain and the Nervous System

Experiencing pain can be a part of life, but living with chronic pain is far from normal. It can be exhausting and affect your ability to live an active life, perform tasks, and get the rest you need. Persistent pain can lead to anxiety, insomnia, and depression. Physical therapy can often reduce or eliminate pain so you can get back to living your life.

What is chronic pain syndrome?

There are two primary categories of pain. Acute pain is often a symptom of an underlying health condition. Recovery can take days to weeks and the pain subsides. Chronic pain, or chronic pain syndrome, on the other hand, usually lasts six months or longer. It occurs in addition to the pain caused by the health condition, which may or may not have healed. It is independent of the original injury or illness that began and can persist long after the pain has gone.

Chronic pain can present in different forms, such as:

• Back and neck pain
• Joint or arthritis pain
• Cancer pain near a tumor
• Pain in the testicles
• Headache, including migraine
• Pervasive muscle pain (including fibromyalgia)
• Persistent pain in scar tissue
• Neurogenic pain due to damage to the nervous system

More than 20% of Americans have chronic pain that affects your work and lifestyle.

What causes chronic pain?

Sometimes chronic pain has a clear cause, such as a long-term illness, cancer, or arthritis. Illness can make your body more susceptible to pain, even after you recover. Injuries, including broken bones, sprains, or infections, can also leave you with chronic pain.

Pain that does not seem to be related to a physical illness or injury is psychogenic painIt is believed that anxiety, stress and depression lead to low endorphin levels in the blood.

Regardless of the specific cause, pain is a function of the nervous system. Nerves around an injury site sense the damage and send signals to the spinal cord and brain. The brain registers the pain and the nervous system responds. Muscles tense, emotions run high, and the nervous system becomes hypervigilant.

This high alert state is beneficial in acute pain. It tells the body that something is wrong, allowing us to protect ourselves from further injury. Once the damage or disease heals, the nervous system functions normally.

Symptoms of chronic pain syndrome

When the nervous system remains in a persistent state of high alert, it often becomes hypersensitive. It can continue the pain even after the original damage has healed. People with chronic pain describe it in different ways:

• To beat
• Stiffness
• To shoot
• Painful
• Burning
• pinch
• Stinging

Poor sleep, mood swings, irritability and fatigue often accompany pain, which increases stress levels and nervous system reactivity. As pain increases, a new vicious circle begins.

7 Common Treatment Methods for Chronic Pain

Chronic pain can limit your quality of life and lead to significant long-term health problems. It can make managing daily tasks, maintaining relationships, and maintaining financial stability challenging. Chronic pain is uniquely personal, and finding an effective treatment becomes a priority.

Your biology and personal history can influence which pain therapies provide relief. However, the treatment combination for one person may not work for another.

1. Physiotherapy

Physical therapy is a highly personalized treatment regimen. Goals may include increased mobility and reduced pain to help you regain full function. Physical therapy includes passive and active treatments. Your program may begin with passive treatments and progress to active methods. Physical therapists play an important role in pain management through various therapies and daily living techniques. Various forms of exercise, including strength, flexibility, balance, endurance, power, and agility, are used to promote and restore normal function, as well as for pain management. While opioids only mask the sensation of pain, physical therapists can also treat pain through hands-on care. Techniques include manipulation, joint and soft tissue mobilization, dry needling, and cupping. This helps to address the pain and target the root of the problem.

2. Contrast therapy

Physiotherapists often alternate between cold and hot therapies. Cold therapy constricts blood vessels. Inflammation decreases when muscles contract and pain signals are reduced. Heat therapy increases circulation by dilating blood vessels. Flooding areas with nutrients and oxygen reduces muscle pain and allows the body’s cells to shed waste. Contrast therapy can reduce inflammation and increase circulation, which loosens tight, sore muscles.

3. Deep tissue massage

Muscle spasms and chronic muscle tension can build up from the stress of a typical daily routine. Cramps can also occur from sprains and strains. The direct pressure and friction applied during massage can release tension in the muscles, ligaments and tendons.

4. TENS (transcutaneous electrical nerve stimulation)

A TENS unit uses varying intensities of electrical current to stimulate muscles, which helps to reduce the occurrence and severity of muscle spasms. It can also increase the production of endorphins, the body’s natural painkillers. You can use just the unit that’s in your physical therapist’s office, or you can have a smaller unit made for home use.

5. Ultrasound

This deep heating technique is applied to your skin. As the heat waves penetrate your tissues, it is believed to improve blood flow and circulation. An ultrasound helps to reduce cramps, swelling, spasms, pain and stiffness.

6. Drug therapy

Over-the-counter medications may be enough to relieve mild pain caused by stiffness, inflammation, and muscle soreness. Typical drug therapy includes ibuprofen, aspirin, naproxen, and acetaminophen (Tylenol). Topical pain relievers that come in sprays, creams, and lotions may also provide temporary relief. Stronger medications for debilitating pain range from prescription NSAIDs, muscle relaxants, and anti-anxiety medications to opioids and steroid injections.

7. Exercise

Exercise is an active treatment and an essential part of the PT toolkit for improving mobility and strength. The brain stops sending constant alerts to the nervous system as the pain subsides. You and your physical therapist will work together to develop an exercise regimen to relieve pain. Examples of low-impact exercises include:

• Swimming
• Stretching and strengthening exercises
• Cycling
• To walk
• Tai Chi
• Pilates
• Yoga

Exercise makes you stronger and trains your nervous system to trust that exercise is safe, allowing it to go from high alert to normal functioning.

If you have pain that comes and goes, physical therapy can help you understand the cause and how to treat it. Everyone responds differently to physical therapy. Contact Us Make an appointment today and learn more about the best treatment options.