Have you ever wondered why a paper cut may be more painful than a stubbed toe or why neck pain feels worse than elbow pain? David Butler, a pain science researcher, has famously stated, “pain is a decision your brain makes.” Every person’s experience with pain and every pain experience is unique and not entirely quantifiable or comparable.

How Does Pain Work?

Let’s take a look at a stubbed toe, for example. You walk into the wall in the dark of the night, suddenly hit the wall, sending incredible pain to your body. Initially, your pain is an immediate response to the noxious stimuli. You get back in bed, and when you wake up, your toe still hurts. Why does this happen? Typically, it means your body is going through its natural healing cycle, and there may be inflammation. Your system then alerts the local nerves and sends your brain a signal to be careful and watch out for any further harm to that area, a signal which your brain interprets as pain. This mechanism is primarily protective and for the benefit of our bodies. 

Every once in a while, you may hear a friend say they once broke a bone and didn’t realize it until later. This phenomenon works in a reverse manner; for whatever reason, your brain does not interpret the information it is given as pain. The brain works both ways, either escalating input or decreasing the input. 

Why Does Pain Persist After Injury?

Sometimes pain does not follow our natural healing of the body; pain should go away once the negative stimuli are removed. In the case where it remains, it is termed persistent or chronic pain. Many people think something is wrong with the injured tissue itself, asking, “Is it broken? Is a ligament torn? Is there scar tissue?” In truth, what it often means is that the local nervous system is now more sensitive and alerting the brain of negative stimuli even when said stimuli doesn’t exist. The pain is being triggered in the absence of pathology or tissue damage.

Fixing Chronic Pain

The best method for rewiring or reteaching the local nerves to not send pain information to your brain is through paced graded exposure. This process works by picking an activity that may be painful, like walking, and performing a specific amount of the movement that you know is painless. Referencing the previous example, let’s say your toe starts hurting after five minutes of walking. You would begin by walking for five minutes and only five minutes, then plan progressive increases that are predetermined and fit exactly for your specific needs. This activity should slowly rewire the brain and decrease the amount of pain you feel on a daily basis. 

A physical therapist can help you with implementing proper paced graded exposure. If you have any questions about pain or struggle with persistent pain, it may be time for you to seek treatment from a physical therapist. Contact your local SetPT today to help relieve your chronic pain!

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