Clinical Somatics, thoughts, Uncategorized

Explain Pain

I’ve been lucky to have had the opportunity in participating in an Explain Pain seminar this weekend, presented by Ben Davies (not the football player), a pain specialist with excellent presentation skills and a vast knowledge. The Explain Pain course is developed by the NOIgroup, Australia’s leading pain science researchers.

We were learning about how pain is an emergent experience with multiple factors coming together, how there is a poor correlation between tissue damage and the experience of pain. We went into detail regarding the chemical processes happening at the synapses in the nervous system, how the nervous amd immune system are constantly remodelling themselves, what happens when we feel tingling from sitting too long and how this differs from the sensation of pain spreading throughout the body.

A myriad of practical tools, questionnaires, strategies, stories to find out what the cause might be and most importantly, how we can help clients (and patients, as most of our group were physiotherapists) make sense of what is happening in their bodies, how we can support them in their recovery through activity, meaningful rest, and current, up to date medical information.

A widespread belief is that if something hurts, there must be damage, so we start bracing, changing how we move and if persistent, adapt our daily behaviour around the pain experience. A lot of people then rush to get an MRI or x-ray to look for a structural reason for their pain and age dependent, will certainly see ‘wear and tear’, disks that don’t look that fresh anymore, joint spaces that don’t look like in the drawing we saw.

As you might have read in recent days, what you see on an MRI is rarely related to why and how you experience an episode of pain. If we take the spine as an example, you can imagine it like a tree being swept and moulded into shape by the wind – the way your spine looks depends on how you use it generally speaking. From a somatic point of view, form follows function and how we move and behave is who we become. A normal scan shows a spine with signs of wear, but that does not mean this wear is hurting you, it simply means you are alive and moving about. So, where does pain come from then?

Pain is an output of your brain, it’s a defense mechanism to warn you about anticipated damage to your integrity (that can be physical or emotional).
When you are in a situation that is potentially threatening to you, you might sense your ‘gut feeling’, that something is off and that you should remove yourself from that situation. You might get a stomach ache or the sense of needing to move.
When you physically stress your body beyond the threshold of your experience, let’s say you set out to run a marathon without preparation, your body will start hurting at some stage – your brain is sending signals to make you stop moving into the territory of actual damage, like a muscle injury.
Pain is an alarm system telling us that we need to change something.

Sometimes, pain persists without ‘reason’, the signal starts to amplify itself and leads to a mistranslation in the nervous system. We become more sensitive to experiences lile touch, smells, sounds.. what used to be normal and not noted becomes translated into a danger message in your nervous system. It’s like the volume regulator in a stereo is broken and everything is just super loud. Vivaldi’s Four Seasons at the right volume is beautiful and uplifting music, over festival speakers it quickly becomes torturous. These changes happen within the nervous system, which has adapted to mismatching information. This is a reversible process,because we are ever changing – our nerves, tissues, thoughts, behaviours are all changing with time.

So things we can look at to maintain or get back to our inherent resilience are in our everyday life: do we get enough sleep? Do we have the knowledge and possibility to fuel our body with good food? Are we supported by our friends and family? Are there medications that might need readjustment? How much do we move and is it appropriate to our current pain threshold or do we need to establish a new base line? How easy can we rest?
Can we find and link positive things in our live to create a stable base for our wellbeing?

You can see, it’s not as simple as popping a pill and continue living a life that keeps us on edge, socially isolated, or without a sense of control.
A wonderful and recommended way into change is through movement.

Somatic Movement in particular has all identified components that have been proven to aid normal function of the nervous system and increased resilience. We create positive habits from which you can grow a more positive outlook, more connections and self-determination.

  • The movements are graded (gentle, non threatening movements in reclined position)
  • novel (your nervous system gets new input that is not linked to experiencing pain while doing them)
  • giving you more knowledge about yourself (body awareness, spatial awareness, motor control)
  • they are taught and practiced in a non-judgemental manner (you are your own measure and there is no aesthetic ideal we need to strive for)
  • the movements are focused on easy, generous breathing which gives your body a rehearsal of resting and activate the para-sympathetic nervous system
  • we highly promote self-efficacy – the movements are easy to learn, can be done without use of equipment and do not foster dependency on a therapist

If you would like to find out more, and how you can directly benefit from practicing Somatic Movement, please get in touch!

Article about the Lancet papers, BBC News (March 21st 2018)

Article in The Guardian

You can find a myriad of resources, articles, videos on www.bodyinmind.org

Leave a Reply