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  • Writer's pictureRebecca Marcus

Understanding Pain

Pain is a normal and healthy sensation. It signals us to bring attention to the area of concern and address it. Living in constant pain is not normal. Tissue healing can occur over 3-6 months, however pain can last longer in duration. Your nervous system becomes hypersensitive, and you begin to process stimuli from the environment enlarged. Think of your brain as an alarm system. It normally takes a burglar breaking your window to set it off, but when someone is hypersensitive and in pain, even a leaf blowing by your window can have the same effect. Often, when in pain your nerves are constantly buzzing with activity and on alert, leaving you less room for activities you used to love. Your nerves are constantly sending messages to your brain. If the message is marked as urgent, it will trigger a different response. Think of stepping on a nail, your nerves will tell your brain and it will send pain to your foot, triggering you to go to the doctor. Now imagine the same situation, but it happens at a busy intersection, and a bus is coming at you. Your brain sees the vehicle as a larger threat and therefore will tell your legs to run, and you won’t notice the nail until you reach the sidewalk. Your brain will prioritize. Pain is 100% produced in the brain to protect you from harm. But don’t underestimate that pain is a real experience. So how do we turn down the alarm system? How can it be two people with the same condition, one is in dire pain, and one is completely fine? External factors, such as your relationships, work place and emotions impact your condition. Think of your pelvic condition as a pot filled with water. The external factors are compared to a flame. If there is an elevation in stress from your external factors, it’ll cause the water to bubble over, causing pain. Getting a speeding ticket is a different experience on your honeymoon, then on your drive home from your loved one’s funeral. External factors will determine the way you react and feel to the same situation. Pelvic pain does not mean anything is broken. A bruise is a form of tissue injury that may not be painful and you may not know how you got it. And sometimes it is just the opposite, one has pain with no tissue injury present. “Know pain, Know gain”- how one thinks and processes pain correlates to how much pain you experience. Education is power. So, now that you have learned all about how pain works, what is the next step? I strongly believe in treating holistically, healing body, mind, and soul. While physical therapy addresses many of the “physical” restrictions, it must be done in conjunction with healing the emotions. I incorporate yoga, meditation, and graded motor imagery into my sessions. Getting patients to increase their aerobic activities, has a calming effect on one’s nerves as well. Dr. David Butler and Dr. Lorimer Mosely, founders of the neuroscience behind pain utilize the concept of explicit motor imagery to help patients re-wire their thought process during painful activities. Explicit Motor Imagery is "the process about thinking about moving without actually moving". During any activity, neurons are firing to wire the activity. 25% on neurons function as mirror neurons, firing with thought or vision of an activity. Imagination isn't just for children! Our brain are so powerful, that even playing out the painful activity in your mind will light up similar regions of the brain you would use for the actual task. On the contrary, thinking positive thoughts, can make a painful experience a better experience. So yes, physical therapy is not all about movement...we exercise the brain too!

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