On The Mend
Joe Divincenzo
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The treatment of chronic pain here in the United States costs over $33 billion per year — that's more than the war in Iraq or the war in Afghanistan.
Since the advent of medicine, humanity has sought a cure for pain — and in searching for that answer, our discoveries have brought forth a compelling finding. The cure for pain does not reside in a high-powered machine or in a radical new procedure, rather, it resides in the ability of health care professionals to educate and empower patients with knowledge of how their bodies deal with pain.
Pain is a normal part of life and a critical device necessary for survival. Despite the amazing evolution of the human brain over the course of thousands of years, our control over how we feel and cope with pain has failed to keep an even pace.
Have you ever said "ouch" when something didn't hurt? And have you ever pulled your mouth away from something that you couldn't tell was hot or cold? We do these strange things because of a term called "perceived threat."
The amount of pain you feel is directly related to how much danger your brain thinks you're in — not how much danger you're actually in. Because pain is partly emotional, fear and anxiety can dramatically increase the level of pain you perceive, thus worsening your pain experience.
Have you ever wondered why a headache hurts more when you're at work or that an "injured" athlete is able to carry on if he's winning the game?
With the advent of brain mapping techniques, clinicians are now able to see which areas of the brain are most active during different tasks. These maps are called neuro-signatures and represent a specific pattern of metabolic brain activity.
You have a unique neuro-signature for everything you do — from playing the violin to signing your name on a check, disciplining children or kissing a spouse — each pattern is different. Fascinatingly, however, the neuro-signatures for physical pain and emotional stress activate the same exact neurons in your brain in near-identical patterns. Think about that the next time your boss is breathing down your neck and you notice your back is a little sore.
In fact, the novice mistake made by most torturers is jumping right into torturing their victim. Telling the victim, in detail, how and when you plan to enact the torture is a much more effective strategy for inducing pain — it allows sufficient time for stress to build and amplifies the pain experience.
Nerves are complex cells only vaguely understood by the best-trained disciples of modern medicine. So if you've ever thought to yourself that stress is making your back pain worse, you're right; we just don't know why — yet.
We do know, however, that effective pain management is a complex, multi-faceted process that works best when all aspects of a disorder are appreciated — not just the physical ones. High-quality research studies repeatedly prove that mitigating the psychological component of pain is just as important as alleviating the physical part.
The longer pain persists, the better your nervous system will become at producing more of it. It's a primitive, protective reflex that lowers your tolerance for activity — that is, of course, if you let it.
If you recently had surgery and were confined to a bed for a week, the best thing you could do to facilitate healing would be to take your brain for a long walk every day down your favorite walking route. Envisioning yourself performing an activity in a normal, painless fashion helps facilitate the recovery process.
Don't be afraid to talk about pain and how it's affecting your life. Discussing it with a trusted clinician may be worth as much as the treatment itself.
Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes "On the Mend" weekly. Questions may be submitted to Joe by email joedivincenzo@comcast.net.
