Let's demystify persistent pain

⏳ “Having chronic pain means having to live with it for the rest of your life.”

The term “chronic” is simply to describe pain that has persisted for more than 3 months. That’s why we prefer the term “persistent pain,” which conveys a less fatalistic message.

“If the medical tests are normal, it means the pain is in my head.”

A normal MRI or X-ray doesn’t rule out pain, but rather the absence of a serious condition.

You can still feel pain at 8/10! Imaging tests don’t detect other factors that can influence pain, such as nervous system sensitivity, stress, sleep, emotions and resulting behaviors.

⚠️ “If I’m in pain, I’m making my injury worse”

Pain is a protective mechanism, just like the immune system. It manifests itself before an injury occurs to prompt us to stop a potentially injurious action.

In the case of persistent pain, this system becomes hyper-protective, sending pain signals more rapidly, even in the absence of real danger.

By avoiding any action that causes discomfort, we risk losing our capabilities, leading us into a vicious cycle where pain appears sooner and sooner with each subsequent movement.

🤕 “If I’m still in pain, it’s because we haven’t yet found the real cause of my pain.”

Here’s how pain can evolve and why it can persist even after tissue healing :

1️⃣ Time of injury: Initial pain is related to damaged tissue, but can be influenced by stress, sleep and diet. The state of the body’s tissues remains an important factor, especially in the presence of inflammation.

2️⃣ Inflammation phase: Pain increases as a result of inflammatory processes and tissue repair (healing, remodeling).

3️⃣ Divergence of pain: Over time, two scenarios may arise:

Pain associated with body tissues (descending curve): Pain gradually diminishes as healing progresses.
Pain less associated with body tissues (undulating curve): In some cases, pain persists even after tissue healing, indicating sensitization of our pain system (persistent pain).

Diagram inspired by Butler, D. S., & Lorimer Moseley, G. (2011). Explain Pain. Noi Group.

🩺 “There’s a specialist with a unique technique who can make my pain go away.”

As seen in the diagram above, many factors other than the condition of body structures contribute to the maintenance of long-term pain.

Here are some factors that will really be able to help you if you have persistent pain:

Finding a therapist with whom you have a good therapeutic alliance
Finding a team of therapists who can help you manage the many facets of your health that may influence your pain (nutrition, mental health, physical activity, stress management, sleep, rehabilitation, lifestyle habits).

If you want to find this team of professionals to help you in your rehabilitation, come and see us at Hexa Physio!

To find out more about the impact of mental health on persistent pain, click here:

https://www.hexaphysio.com/en/impact-of-mental-health-on-chronic-pain/

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