Some times pain can last longer than anticipated. Some people end up living with pain for several years. It can affect your every day living. It is important to understand what pain is and how it can become persistent, in order to help improve pain and not let it take over your life.

First let’s look at the nervous system. If you added all the nerves in the nervous system together, end on end, an average sized human adult would reach nearly 45 miles! Together they form a remarkable network of communication that moves us, makes us feel, hear and see things and generally allows us do everything we do!

Our brain receives signals from all over our body, uses the information along with our parts of the brain such as memory and emotional centres and decides “are we in danger”?

If the brain believes we are in danger it will often use pain as a motivator to try to get us out of danger. Therefore whether we have a recent acute injury or a problem for several months or years, pain is 100% of the time produced in the brain. Sometimes the brain doesn’t always get it right and we feel pain despite there no longer being an injury. Some important points to consider are:-

  • Pain does not indicate the severity of injury!
  • Sometimes lots of damage can result in no pain!
  • Sometimes no damage can result in lots of pain!
  • Sometimes an injury can heal and we still feel pain!
  • It depends what our brain decides!

Persisting pain can be influenced by many things. Recent imaging of the brain has shown that stress, memory, anxiety and depression can all influence pain and turn the pain levels up and down.

This is why an accurate and detailed assessment needs to be taken with persisting pain problems to determine what is the main cause and what would be the best management strategy to take. Management can involve your regular physiotherapy interventions such as manual therapy and exercise. However it is also important to identify things you are doing day to day that may be contributing to the problem. Often your own beliefs about what is causing the pain can be inaccurate and these beliefs, if not helpful, need to be challenged.

Stress triggers needs to be identified and possible multidisciplinary intervention such as appropriate medication from you GP, psychological intervention to help find ways of dealing with stress anxiety and depression can be used if appropriate.

At Redbourn Physiotherapy we have physiotherapists trained in treating persistent pain problems. They can help you identify the main problem and give you an effective management plan, which will reduce your pain and help you get back on with life!