You cannot experience pain without a brain. A person in a coma cannot experience pain. Pain is a result of a conscious mind, previous experience with a similar event and the fears and worries that accompany the event.
If any of these processes are disturbed, acute pain can turn into chronic pain. The old school definition of chronicity only took duration of the pain experience into account. Recent school of thought advocates that chronic pain is not distinguished by its duration, but the “body’s inability to achieve normal physiological homeostatic levels” after injury (Loeser & Melzack, 1999).
Chronic pain is real. It is not “in your head” in the crazy roll your eyes and point to your head kind of way. It is in your brain, way longer than it is in your torn ligaments or disc bulge. The pain is there, despite the tissue healing.
Why does this happen?
This happens when all of the acute pain “events” are maintained.
- Peripheral sensitisation is maintained, because the nerve is continuously generating inflammation.
- Spinal cord sensitisation (irritation) is maintained together with all the side effects (allodynia, hyperalgesia, referral).
- Brian changes can cause an actual loss of grey matter, visible on an MRI. Changes can further lead to a change of your body’s map in your brain. Now the previously injured area is taking up all the space. It is all consuming. You may feel as though you are forgetful, emotional or even experience a change in your personality. It is not in your mind, it is in your brain. There is hope, noninvasive (no surgery) treatment to change your brain again.
We strive to treat the source of the pain. Recent tissue damage causes acute pain. We will treat the injured area. We make use of different techniques that a suitable for your specific injury. Treatment will be mostly hands on with a few things that you can do to hasten the healing process at home.
We have established that chronic pain is not the result of tissue damage that happened now. The initial injury might have happened years ago. Your body has the ability to heal itself. We expect that the damage has healed. But the brain, spinal cord or extremities are now keeping the noxious stimuli going. We need to treat the source of the problem, or it will not go away.
You can expect a lot of talking during your consultation. We need to make sure that you understand what is going on in your body. Then we can treat the brain. Re-wire it, to stop maintaining the unnecessary pain experience. We will attempt the re wiring with graded motor imagery. This is a relatively new treatment approach with 3 different stages. Everyone moves through the stages at their own pace. We aim to stop the malfunctioning of the entire nervous system.