“Pain doesn’t always equal harm.” 

This is interesting advice coming from a physical therapist who specializes in pelvic and orthopedic rehab where she frequently encounters chronic pain. Chronic or no, the underlying problem remains the same. 

Mackenzie Van Loo makes a point, “Pain stops us from living a full life.”

When we are in pain, we have options on how to respond. We can sit back and rest, putting our favorite activities on hold lest we risk further injury. Or, we ignore the pain and cause further harm. Pain is a puzzle of sorts and widely misunderstood. But pain doesn’t always mean the body is being harmed. 

There are conditions where pain can be perpetuated – or continued – by the nervous system. Let this sink in for a minute. The nervous system can make a person more sensitive to pain and can cause painful symptoms to persist, even in the absence of harm.

This can be mind-blowing to many people.

Understanding Central Sensitization

When pain lasts for longer than three months, central sensitization starts to occur, which is the beginning of chronic pain. Chemically and neurologically, the brain begins to change. So too does the physical area where the site of injury exists. Cells make new neurotransmitter receptors in this area, and nerve growth increases. All of this is done to allow the brain to detect and gather more information about the injury. 

Everyone experiences pain differently; however, perception and reality may not align for some people with chronic pain. While the pain is genuine, the brain is what changes the perception. If we didn’t have a brain, we wouldn’t have pain. 

Stress, Pain, and Sleep

The neurotransmitters for coping with stress and pain are the same. Some of these neurotransmitters, serotonin, and dopamine, are natural pain and stress fighters responsible for reducing pain and boosting pleasure. They are made in the gut while we sleep. If sleep and diet are compromised, the body cannot make more neurotransmitters to deal with stress and pain appropriately. 

How to Limit Pain

The first thing to help address chronic pain is to identify the things that make it worse. Rest isn’t always best. Mackenzie recommends “relative rest,” which means incorporating movements or activities that won’t worsen the pain. For most injuries, the sooner muscle activation begins, the quicker healing will occur. It is merely a matter of reprogramming the brain and nervous system on how to move better. There are obvious times where strict rest is important, such as after significant trauma or surgery, but a physical therapist will help you find how to navigate that well.

Fear and Recovery

Fear often gets in the way of recovery. As stated at the beginning of this article, fear can stop us in our tracks. When we stop moving, we inhibit the lubricating fluid production necessary for transporting nutrients to injured parts of the body to promote healing as well as put the rest of the body at risk for deconditioning.

Physical therapists, like Mackenzie, are specially trained to diagnose and then treat the underlying cause of pain effectively. They will then identify more effective ways to move that decrease stress on specific areas of the body. This knowledge allows a patient to begin to feel better by incorporating movement without fear of further injury. 

The same parts of the brain that drive anxiety and depression also drive pain. A well-trained physical therapist will provide education to help them identify real pain without the brain-altering their perception. 

If you are concerned about chronic or persistent pain, schedule a physical therapy evaluation. You do not need a referral for this appointment, and the knowledge you gain from an assessment may put you on the road to recovery. 

Life is short. Don’t let pain keep you from experiencing it fully.