There are many definitions for persistent pain. This is usually the indicator that we have not totally grasped the whole concept. An accepted definition is:

 “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”  The International Association for the Study of Pain.

Acute pain protects us from hurting ourselves or tells us when we have hurt ourselves. In addition, it can also tell us that a disease may be lurking. Persistent pain becomes an experience that persists long after the healing period of 3 months following an injury, or sometimes that comes on for no apparent reason.

Science has made some great breakthroughs over the last 15 years in answering the question – “Why do some people live in such pain?”. We now have the science to see what is happening in the nervous system of persistent pain sufferers. What medicine is still struggling to come to terms with is the EXPERIENCE of persistent pain for each person who lives with this ongoing problem.

YOU ARE THE EXPERT ON YOUR PAIN EXPERIENCE

EVERY PERSONS’ EXPERIENCE OF PAIN IS UNIQUE

Over the next few months we will work through the “Pain Loops” chart I drew up for our Alchemy In Motion patients. It is by no means complete or exact but it is a start. The hope is that you will gain some insight into why you or a loved one experiences so much ongoing pain. We know from the research that simply understanding some of the inputs into the pain system can help in recovery. We are also starting to realize pain is a “phenomenon” that we need to observe and work with from biological, psychological and social (BPS) perspectives.

WARNING: PERSISTENT PAIN IS COMPLEX

(& so is this chart a little)

 

Please feel free to download or print out this chart. I often have patients pin it up to keep referring back to it on pain flare or good days. This can help them to identify the factor that affected their pain ( …sometimes this isn’t possible).

Reading the chart: The inputs to the brain are at the top. As you can see there are many pain influencing “input” possibilities. These mix together in what we call “The Pain Neuro-Matrix”. This is a made-up concept used to try to understand the workings of the brain. Inputs are interpreted by the brain (and its body), resulting in “outputs”. You will see there are many words/phrases around the loops, some positive and some not so. On the right are the more favourable, and on the left are the less favourable outputs.

PERSISTENT OVERPROTECTIVE NUISANCE PAIN IS AN EXPERIENCE INFLUENCED BY THESE OUTPUTS.

The outputs are fed back via the loops (become inputs) and there is another matrix event with results at the next output. These loops may be short-lived or may persist for many years. The aim is to patiently move towards the right and jump off this cycle!

We will be going into detail each month on every part of this Pain Loops Chart. Board the train by having a look at this chart and we will see you next month to start the journey!

 

Blog by Robin Kerr ( Physiotherapist)