What is my pain system?
Just like we have a digestive system and circulatory system to make our body work, we also have a system responsible for helping us with pain. Your ‘pain system’ comprises your brain, spinal cord and all of your nerves.
What is persistent pain?
Believe it or not, pain is useful. It helps us learn and keeps us safe from harm. When working normally, the ‘pain system’ gives a warning signal if you are in harm's way. For example, standing on a sharp nail, the pain tells you to move your foot. This is called acute pain, it is a warning signal and tells you not to stand on sharp nails! If your body has been injured it usually heals and the pain will settle with time.
Sometimes the ‘pain system’ goes wrong and carries on sending warning signals after this healing time. This is unhelpful as it does not help the healing process as it has already finished. This type of pain is known as persistent pain.
Pain does not always mean harm
Frustratingly, the ‘pain system’ is not always as reliable as you might think. Sometimes dangerous and harmful situations can be completely painless, for example carbon monoxide poisoning which can kill you is pain free. On the other hand there can be severe pain with little or no actual harm, for example a papercut.
What causes persistent pain?
Often there is no clear reason why the ‘pain system’ sometimes goes wrong. Persistent pain is not in your imagination and most certainly is not just in your head. The healthcare system now thinks that persistent pain is due to changes that occur within our pain system (brain, spine and nerves). Factors such as worrying about the pain, stress, poor diet and lack of sleep are thought to play a part making the ‘pain system’ more sensitive. With a more sensitive ‘pain system’, simple things like movement, touch or even thinking about your problem can hurt.
What about an x-ray or scan?
Pain can not be seen on an x-ray or scan. In most cases, having an x-ray is not useful in helping your problem to get better. Of course, in certain situations they are important and necessary, but often the results will show you things that are meant to be there or normal for the age of your elbow. That might mean that in a number of cases, what the x-ray shows is not really necessarily related to why you are in pain. This is likely to be why your GP or physio may have said that it is not be needed to help with diagnosis and treatment.
What treatment is there?
In most cases of persistent pain, there is no specific treatment that will make the pain go away completely. There are however many things that you can do to help yourself .
What can I do to help myself?
PACING: Are you doing too much on your good days? And then very little on your bad days? It is important to stay active. However, if you overdo things this can increase the sensitivity of your pain system. Therefore aim to break up activities that aggravate your pain by building in short breaks.
EXERCISE: Exercise is the best medicine for your body. It is important that you try and start some form of regular exercise. Exercise can mean anything and the best form is doing something you enjoy. Exercise and activity can help ease persistent pain and also it will maintain or improve your strength and flexibility which will support your joints with all your daily tasks. It can also help the rest of you body work better and help manage issues such as stress and sleep complaints.
RELAXATION: Relaxation is often undervalued but is a very good tool in your daily management of your pain. Relaxation, mindfulness or meditation can allow you decrease tension in muscles and unwind the mind.
Ideas for relaxation could include:
reading a book
watching a movie
relaxation or breathing exercises
Anything that you enjoy doing.
SLEEP: Sleep is when your body recharges itself. It can be difficult when you are in pain to get a good night's sleep and frustratingly lack of sleep can increase the sensitivity of the pain system. This video gives you some ideas on how to improve your bedtime regime.
DIET: The food you eat helps to feed the healthy bacteria in your gut which have a large effect on your immune system. Your immune system helps fight infection and illness and is part of the ‘pain system’. A diet where you aim to eat non-processed natural foods free from additives, colourings and added sugar is good for feeding your gut what makes it work best.
What else can I do?
Some persistent pain is helped by the right medication and it can allow you to become more active. Check with your GP or Pharmacist to ensure you are receiving the most effective medication. Sometimes persistent pain isn’t helped by medication and therefore, exploring the factors listed above is often best.
You will be eligible to attend our Positive Pain Management Group. This is a 4 week course which will give you a greater understanding of your pain and how to manage this on a daily basis. If you are interested, please discuss this with your physiotherapist.