Persistent Pain

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Persistent pain is common and effects over 14 million people in the UK alone. It often does not respond to conventional medical interventions and needs a different kind of approach, but there is plenty you can do to manage your pain yourself with the support of your osteopath, your family and loved ones.

Acute pain

We all feel pain from time to time. When someone injures themselves, specific nerves recognise this as pain, which in turn triggers the body’s repair mechanism. As the problem resolves, the pain tends to improve and usually disappears within 3-6 months. This type of pain could be considered to be beneficial: if it hurts, you are likely to try and avoid doing whatever it is that has caused the pain in the future, so you are less likely to injure yourself in that way again.

Persistent pain?

Persistent pain occurs when your pain system becomes overprotective. Occasionally the pain continues even after tissue healing finishes, it becomes known as persistent (or is sometimes referred to as chronic) pain. This type of pain is not beneficial and is a result of the nerves becoming over-sensitised, which means that a painful response will be triggered much more easily than normal. This can be unpleasant but doesn’t necessarily mean that you are doing yourself any harm simply by moving. In fact, by avoiding physical activity and resting more your pain system can become even more protective. You could think of this as a sensitive car alarm that goes off in error when someone walks past. There are several things which can result in pain becoming persistent.

Persistent Pain Causes

  • Mental State
    • Stress, tiredness, or feeling a bit down can all magnify your bodies response to the pain alarm and magnify its response or prolong it long after healing has been completed.
    • It is not unusual for people to experience pain more when further significant stressful events, fatigue or periods of anxiety or depression occur.
  • Nutrition
    • Research has shown that diets containing highly processed food, sugary foods, saturated or trans fats can result in chronic low-level inflammation which is associated with persistent pain.
  • Sleep
    • Your body needs sleep to help it repair. Whilst you are at rest the body’s natural medicine chest can fully engage and to address any damage that needs repair, and to remove the by-products of the repair processes (inflammation).
    • Poor sleep slows down the healing process.
  • Professional Advice
    • Many years ago it was often the advice to rest and to not do any exercise if you had a bad injury. The professionals consulted would recommend lying on your back for weeks at a time to help resolve back pain or would limit your activity as a young teenager to help reduce growth pains.
    • It is not unusual to hear patients say, “I was told that I would get arthritis as I injured my hip playing football years ago” or “I should stop doing my favourite sport as I would cause further damage.” Yes, in some cases this may be true, however, in most it is now considered an outdated point of view.
  • Exercise
    • It is not unusual for people to stop exercise due to pain. A particular activity may feel like it is causing pain, or you had an injury playing a sport you loved.
    • Persistent pain can result in change in our perception of what we can do and can result in the avoidance of physical activity.
    • As a result our pain response can become more active to the slightest of challenges, completely out of proportion.
  • Medication and Scans.
    • Some patients have been prescribed strong painkillers or have undergone unnecessary scans, which do not show the actual cause of the pain.
    • These can reinforce the perception that there is damage when in fact the body has healed itself, or patients can become dependent on the medication that is in fact masking the healing process.

How to address persistent pain.

When your persistent pain starts to take over your life and stops you from doing the things you love, and enjoying time with your friends and family, it is important to have strategies and techniques to help you gain back control. As an osteopath I work with you to determine the true nature of your pain, it's causes and the factors which are stopping it resolve. This means that I will spend time asking you about all aspects of your life which may be maintaining the pain, as well as the original onset of the pain. Together we will then look at various strategies and actions that you can put in place to help tackle your pain. The aim will be to produce a plan which is achievable and one which you can see the results from. There will be homework such as exercises for relaxation techniques for you to try.

Managing Persistent Pain

  • Healthcare Professionals.
    • Osteopaths will identify & treat any structural cause of pain & help plan your way forward.
    • Ask your doctor for help in reducing your pain meds, don’t cut them all out immediately.
    • Understanding pain is an excellent resource which offers a great explanation of persistent pain as well as further advice and great resources on how you can help yourself such as the video Tame the Beast . You can also read the British Pain Society advice here
  • Mindfulness
    • Mindfulness or meditation are great tools to help you manage your mental health and emotions related to your pain
    • They will help you to learn to breathe in a restorative calming way.
    • These are great apps to try out mindfulness Calm and Headspace , both of which you can try for free, and use short meditation sessions to help relax you in different situations.
  • Nutrition
    • Eat a well balanced Mediterranean style diet, this has been associated with a reduction in inflammation BBC - What is an anti-inflammatory diet?
    • a wide range of vegetables and fruit will help reduce inflammation
    • reduce sugar which increases inflammation, and saturated and trans fats which slow down recovery.
  • Exercise
    • Keep active, performing strengthening exercises and stretches can help,
    • By challenging the tissues in your body you will become stronger and more resilient, reducing the need for your pain response to be so high and so reducing your protection setting.
    • For exercises suitable for you see your Osteopath so that they can decide which are the most appropriate.
  • Sleep
  • Pacing
    • Plan your activities so that you don’t trigger a flare-up of your pain
    • Mix up some of the more sedentary with exercises which will help you to stretch and strengthen.
    • Be active most days even just for a short while.
    • Setting goals and priorities
  • Track you progress and celebrate your achievements.
  • A good resource on pacing is available from Live Well with Pain
  • Healthcare Professionals.
    • Osteopaths will identify & treat any structural cause of pain & help plan your way forward.
    • Ask your doctor for help in reducing your pain meds, do not cut them all out immediately.
    • Understanding pain is an excellent resource which offers a great explanation of persistent pain as well as further advice and great resources on how you can help yourself such as the video Tame the Beast . You can also read the British Pain Society advice here
  • Mindfulness
    • Mindfulness or meditation are great tools to help you manage your mental health and emotions related to your pain
    • They will help you to learn to breathe in a restorative calming way.
    • These are great apps to try out mindfulness Calm and Headspace , both of which you can try for free, and use short meditation sessions to help relax you in different situations.
  • Nutrition
    • Eat a well-balanced Mediterranean style diet, this has been associated with a reduction in inflammation BBC - What is an anti-inflammatory diet?
    • a wide range of vegetables and fruit will help reduce inflammation
    • reduce sugar which increases inflammation, and saturated and trans fats which slow down recovery.
  • Exercise
    • Keep active, performing strengthening exercises and stretches can help,
    • By challenging the tissues in your body you will become stronger and more resilient, reducing the need for your pain response to be so high and so reducing your protection setting.
    • For exercises suitable for you see your Osteopath so that they can decide which are the most appropriate.
  • Sleep
  • Pacing
    • Plan your activities so that you do not trigger a flare-up of your pain
    • Mix up the more sedentary with exercises which will help you to stretch and strengthen.
    • Be active most days even just for a short while.
    • Setting goals and priorities
  • Track you progress and celebrate your achievements.
  • A useful resource on pacing is available from Live Well with Pain
For more information on how to manage your persistent pain, speak to your osteopath. We all feel pain, but persistent or chronic pain is not beneficial, osteopathy can help you manage it. #osteopathyworks #osteopathyforhealth