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The complex system of chronic pain unraveled

At Waves Leuven we have a strong interest and profound experience in supporting people with chronic pain. Within this blog series we would like to provide information for people who experience chronic pain, or who have a relative with chronic pain.

Based on both scientific evidence and our own experience as therapists, we would like to share our knowledge about the complex nature of chronic pain as literature shows that a good insight and understanding of pain is very important in recovery [1]. In this blog series we will guide you through the world of our complex and very interesting pain system, provide you a framework to understand this system and offer you guidelines in the management of your own chronic pain.

What is pain?

Pain is a complex process which can be divided into acute and chronic pain according to its duration. It’s also a normal and healthy phenomenon and even very useful! It protects us from impending tissue damage and signals when we are in danger. For example, pain causes us to pull back our hand when it’s too close to a source of heat. In this way we prevent damage.

What is acute pain?

In acute pain our nerve endings are stimulated by a source of damage. This can be from many forms including hot/cold, injury or impact. This signal of damage is transmitted from our nerve endings to the central nervous system which is responsible for processing all this input. The central nervous system will produce pain that warns you when your body is in danger, and to which the body may react (e.g. pull your hand away from the heat source, stop walking,…). The production of this pain signal is highly multifactorial and contextual. When you are in danger, a small injury will be perceived as less dangerous.  Are you a violinist? A small wound on your finger may feel much more threatening than for someone who does not use his fingers very intensively.In other words the same stimulus can generate more or less pain, depending on personal and contextual factors [2].

Did you know?

Did you know that 0.004% of the population does not feel any pain? At first sight, this may seem wonderful. However, these people do not have a convenient life. They don’t stop walking when they have an injury, they burn themselves on hot food or they notice late that a wound is infected. They are often in danger without being warned by their bodies.  A life without pain is not easy, and not recommended! Having pain is useful, and often life-saving [3]. However, pain can also be debilitating…

Some people think that to be strong is to never feel pain. In reality, the strongest people are the ones who feel it, understand it, and accept it.”

– unknown

What is chronic pain?

When pain persists for more than three months it is referred to as chronic pain. In most cases, chronic pain is not caused by an injury [2]. Over time your body has been able to repair the injury but your alarm system remains active. Your nervous system has become hypersensitive and the pain is no longer a reliable warning signal. This type of pain is not functional and no longer has a helping or protecting role.

As many as 19% of adult Europeans experience chronic pain throughout their life [4]. Hence chronic pain can be considered a major health problem where adequate rehabilitation and follow-up care are of utmost importance.

In the following blogs within our Pain Blog series, we will go into more detail about the complexity of chronic pain, its potential impact on daily life and the latest scientific and in practice advice on how to manage pain

 

Do you experience chronic pain? We recommend seeing a physiotherapist that specialises in this area. Keen to know if there is one in your region? Contact us, we are always here to help near and far. You can reach us at hello@wavesleuven.be or 016/58.04.14

Author: Sarah De Canniere
Physiotherapist at Waves specialised in chronic pain

Disclaimer: this site cannot and doesn’t contain medical/ health advice. The medical/ health information is provided for general informational and educational purposes only and is not a substitute for professional advice. Accordingly, before taking any actions based upon such information, we encourage you to consult with the appropriate professionals.

References

[1] Tegner, H., Frederiksen, P., Esbensen, B. A., & Juhl, C. (2018). Neurophysiological pain education for patients with chronic low back pain: A systematic review and meta-analysis. The Clinical Journal of Pain, 34(8), 778–786. https://doi.org/10.1097/AJP.0000000000000603

[2] Butler, D., Moseley, L., & Sunyata, A. (2016). Begrijp de pijn (2nd ed.). Adelaide, Australia: Neuro Orthopaedic Institute and Noigroup Publications.

[3] Nagasako, E. M., Oaklander, A. L., & Dworkin, R. H. (2003). Congenital insensitivity to pain: An update. Pain, 101(3), 213–219. https://doi.org/10.1016/S0304-3959(02)00441-0

[4] Mills, S. E. E., Nicolson, K. P., & Smith, B. H. (2019). Chronic pain: A review of its epidemiology and associated factors in population-based studies. British Journal of Anaesthesia, 123(2), e273–e283. https://doi.org/10.1016/j.bja.2019.03.023

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