What is Pain?
Your pain nerves are trying to stimulate your brain all the time.
Thankfully most of the signals never make it through as other nerves stop the messages from getting higher up.
The nerves that send pain are called nociceptive nerves. Nocioception is the detection of a noxious or unpleasant stimulus. Pain is the unpleasant sensation or emotion of damage or potential for damage. The nerves that calm nocioception are stimulated by movement.
However, loss of movement of an area means the suppression is reduced and pain can start to be felt.
Anyone who’s sat through a long film will know that. The sensation of stiffness is your body literally telling you to move so that you don’t damage it.
The brain itself can also suppress pain from above if it is busy doing other tasks that are deemed more important, i.e. running away from danger or doing something more pleasurable.
Pain is felt when the impulses from pain nerves actually manage to reach the outer cortex of the brain. So you become aware of the pain at that time.
To achieve this you must have increased excitation of the pain nerves. This can be down to an increase in the stimulus or by making it easier to fire the nerves.
The inflammatory state of your body, stress and emotional responses can influence pain generation.
If your body is in an inflamed state then you will generally be more likely to experience pain. Or if tissue is injured, chemicals released by the damaged cells lead to easier pain transmission and you feel pain. also heighten the
So, what is the best pain treatment?
It is possible to have a lot of wear and tear and have no pain at all. Similarly you can be in agony when there is very little damage showing. So if you have a scan of a recently injured joint that was previously pain free and it shows degeneration or a tear of a structure don’t go straight for the surgical option. There is little correlation between tissue damage and pain.
You may be in pain simply because the pain nerves are more excited and the suppressive mechanisms aren’t working. If this is the case surgery might not help as it will also lead to inflammation. The important part is reducing your inflammatory response.
Surgery should always be a last resort, once it’s done it can’t be reversed. There are risks of infection and risks of further pain due to the inflammation and excitation of nerves from the surgery itself. In some cases this can trigger a complex pain syndrome that is self fulfilling and perpetuates as the nerves themselves create more inflammation.
The natural approach begins by activating the neurological mechanisms that suppress pain. Stimulation of these nerves anywhere in the body can help, the strength of the effect is variable depending on what area is stimulated and is related to the representation on the brain itself. Movement, mobilisation, manipulation, taping all help reduce pain. However they have to be applied correctly to ensure the balance of neurological activity is helping rather than hindering.
If the physical therapy approach you choose isn’t successful, try a practitioner in a different discipline such as chiropractor or osteopath, or vice versa. Or even two different practitioners within the same profession as they do work quite differently a lot of the time. After you’ve exhausted all options consider the surgery but remember the pain won’t just disappear after surgery, you will still have a period of 6-12 weeks of recovery and rehabilitation to go through.
Also you should look closely at your diet. Lack of fresh fruit, whole foods such as nuts, seeds, dark leafy green vegetables and oily fish can mean the body does not have the raw materials to create anti-inflammatory chemicals. Furthermore smoking and alcohol can aggravate inflammation.
The use of the painkiller Gabapentin alongside manipulation and stimulation can also be helpful to suppress the nerves so that treatment can be gently started in chronic pain syndromes.
We do also recommend the use of Non Steroidal anti-inflammatories in cases that are generally inflamed and slow to respond. However, long term use could cause gut inflammation and create further inflammatory reactions.
