Pain should be like a welcome houseguest: It’s handy to have around…but even better when it leaves!
Short-term acute pain is an important warning system. When acute pain slides into chronic pain, however, lives change.
Acute pain is a natural phenomenon. We need it for survival. Pain sends a strong message to our brain that something is wrong. It protects us by forcing us to stop what we are doing and instigating healing processes.
Let’s say you are walking on the beach and misjudge your footing in the soft sand, twisting your ankle. Suddenly, you feel a sharp pain shooting up your leg. That sharp pain is the signal for your body to stop and protect yourself. The pain stops you from standing up. Then, the tissues around your ankle begin to swell, protecting the joint more by restricting any movement. The swelling also increases the blood supply to the ankle, bringing white blood cells to mop up the damaged tissues.
Your body mounts response to prepare to flee or fight to survive. Your blood pressure rises, which might cause you to feel faint. Your digestion slows down so your body doesn’t waste energy digesting your lunch. And, your immune system focuses on the injury, which means there is less energy left to fight other infections. Right now, your brain considers your injury more dangerous than any other cold or flu that is floating around. All of these consequences of this initial ankle injury are designed to force you to protect yourself and survive.
All of this is perfectly fine and natural … in the short term. And, it would be logical to think that once the immediate danger has passed, our brain would stop the warning signal, let go of the pain and life would go back to normal. However, for reasons that we still don’t understand, some people, including myself, slide into chronic pain.
Chronic pain is pain lasting longer than 12 weeks. It can be caused by many conditions, even those you might consider insignificant or minor. The slide into chronic pain usually occurs silently and sneakily. Not everybody has the same path into chronic pain, nor the same lifestyle restriction, but the following indicates how easily this slide can happen.
Let’s return to the ankle injury on the beach.
So, you have twisted your ankle on the beach. After you catch your breath, you might hop on your unaffected leg to the nearest rock and sit down. You take the next few days off work, and then you use crutches to get around when you return to your job. Obviously using crutches is difficult, so you try and alter your work tasks to reduce standing and do more at your desk.
Using crutches to get around is tough, so you cancel the trip to the movies you had planned with your friends. Cooking is also a little tricky when you are on crutches, so you get take-out ‘just for a few nights’, rest on the couch and catch up on Netflix.
Fast forward six months and that ankle is still giving you trouble. For reasons that the doctors can’t explain, your ankle still hurts, even though no damage shows in any of the tests/X-rays/MRI scans that you have. Your doctor increases your pain medication, which makes you drowsy, but that is better than living with pain.
You are too drowsy from the medication to concentrate for too long, so you stay home most days now, watching TV. You are worried that if this pain does not go away soon, you will run out of money. You even had to cancel your Netflix to save money.
This ‘warning signal’ of pain is carrying on too long. And if that sounds like your story, finding a way out can be difficult. “Rewiring pain” might challenge you to think about how whether you have slipped into a pain lifestyle, and it will provide some answers as to how to get back out.