By Matthew Gallegos, PT, DPT
Pain is the unpleasant sensation we experience in response to the brain’s interpretation of a “threat” or “potential threat” to the body, usually following a traumatic event. The body’s nervous system (brain, spinal cord, and all branching nerves) works as an alarm system to detect these threats to the body and activates once the threat occurs. Think of stepping on a nail, for example. This state of alertness increases awareness and messaging to the brain which stimulates a reaction for the body to respond to the threat. In the example of the nail, you immediately move the foot.
In normal situations, this hypersensitive nervous system remains alert for the period of time necessary to protect the injured area from further damage and allow healing to occur. However, when this pain persists even following complete tissue healing (usually 3-6 weeks for the nail example), it becomes “chronic”. In this unfortunate situation, the body’s alarm system remains alert and hypersensitive to harmless activity, although the tissue has completely healed.
Factors such as stress, anxiety, depression, poor spiritual health, poor diet or sleep hygiene, or even inactivity can foster even greater pain and discomfort as the brain’s misinterpretation of the symptoms remains hypersensitive to the body’s inability to regain homeostasis. With the busy, go-go-go nature of our current culture, it is no wonder that, according to the American Physical Therapy Association, an estimated 116 million Americans suffer from chronic pain annually, costing the U.S. over $560 billion in medical treatment, lost work time, and lost wages.
The good news??? Physical, Occupational, and Speech Therapies can each play an integral role in the treatment of chronic pain, allowing the patient to regain his or her previous state of mobility and decrease reliance on pain medications.
NEUROANATOMY AND PAIN
With 400 nerves making up the body, and extending over 45 miles long, the nervous system has a profound role in our interaction and manipulation of the world around us. Additionally, although the nervous system in whole only makes up 3% of a person’s bodyweight, it accounts for 20-25% of the available oxygen in the blood – meaning that when an injury or redirection of nutrients from a nerve occurs, we can experience an unpleasant cascade of symptoms.
Each nerve has a specific role, whether it be sensory, motor, or integrative in nature, and requires 3 things to function appropriately: adequate space, movement, and blood flow. Unfortunately for us, when one of these necessities are compromised, the body’s interpretation can become a painful and long-lasting experience. Diagnosed in many physical and occupational therapy evaluations, nerve hypersensitivity (the nervous system’s increased sensitivity to outside stimuli) is one dysfunction which can dramatically affect mobility, daily activities, and general well-being. The treatment of chronic pain, when nerve hypersensitivity is present, is treated with specific “nerve desensitization” techniques that sooth neural tension, help build tolerance to movement, and retrain nerves to fire properly to aid in regaining full functional mobility.
WHAT CAN YOU DO IF YOU HAVE CHRONIC PAIN?
One treatment intervention therapy professionals utilize is called PNE (Pain Neuroscience Education), which focuses heavily on the management of chronic pain. It is a research-based treatment approach for teaching patients about “their individual pain experience” and how it relates to the neuroanatomy and psychosocial aspects of their lives, unique to each individual, using metaphors, simple diagrams, analogies, and progressive neuroeducation techniques. It educates patients on topics relating to the homunculus (the brain’s internal mapping of the body’s interpretation and processing systems), desensitization of a chronically inflamed nervous system, pain management techniques surrounding the mental processes and understanding of pain, stroking techniques used along the peripheral distribution of nervous supply, as well as mirror therapy to retrain a person’s perception of “normal movement”. Essentially, it is retraining and re-educating the brain and the nervous system to work optimally and functionally in a normal “resting state.”
Lastly, and in line with the mission of Virginian Rehabilitation and Wellness, Inc., the care rendered in treatment of chronic pain must remain individualized, delivered with compassion, and perfected with clinician experience – all of which remain high priorities amongst our clinicians. We value the process of getting to know our patients from day one, so that we can best tailor a treatment plan to address your specific and evolving impairments, weaknesses, and physical debility – all ordered toward regaining your functional freedom.