“is it all in my head?”, yes and no, but regardless, pain is real to the person who is suffering from it. 

Chronic pain is defined as pain that is experienced the majority of the time, and of 3 months or longer in duration. A more complex condition, it is the result of damage to tissue from an acute episode that has resulted in a change to the nervous system and pain signalling. 

Statistically, 1 in 5 Australians are suffering from chronic pain (Australian Institute of Health and Welfare, 2020), with the large proportion of these being female, over the age of 45, reporting problems with engaging in everyday life and have long term conditions in association with their pain.

Chronic pain affects people in many ways, from social life, relationships, work, and mental health with reported episodes of depression, anxiety, sleep disturbance and fatigue.

So what can we do about it? First we must understand that the body and mind have a memory of pain, it is a safe guard response to danger. Going back to 1000s of years of evolution, pain alerts us to danger. However, sometimes these messages get confused, especially when pain is significant or continues on for too long. In short, the brain and body get use to the pain state as a normal state, and hence we have chronic pain.

Our nervous system is a learning processor, and while we can’t change the memory of pain, we can create new messages that inform the system again.  This is called neuroplasticity and it’s brilliant. This is where therapy with a qualified physiotherapist comes into play.  Rather than treating a body part, or condition, we have to look at the person as a whole and consider the psychosocial factors involved in their recovery. Therapists who look beyond the body part, consider these factors, and use approaches such as Cognitive Behaviour Therapy informed treatment that is based around changing peoples beliefs about the body. 

Our physios will use manual therapy as needed including things like massage, needles, stretching etc, but with a heavy emphasis on graded exposure therapy, activity and exercise based therapy, to start to re-educate the nervous system. By increasing function, pain will often reduce. Quality of life goes up and so does self reported well-being. This can be an ongoing process, which is good in that it’s unlimited what we can achieve, but it can be lengthy and as you can imagine, timeframes for early stage therapy can be hard to predict. So it’s important that you set down some achievable and realistic goals with your therapist that can be monitored and measured as you go along. Compliance with therapy can be difficult when you are in constant pain, and can lead to early drop out of therapy. Speak to your therapist about your expectations, and ask lots of questions, knowledge is power and it’s time you took some of that power back.  

Sam and Andy