Your body is comprised of a series sensory feedback loops that help you interact, engage and react to the world around you; you are aware of some of them, but there is a lot going on under the surface that you likely don’t appreciate. Your brain is constantly barraged by information from your eyes, ears, skin, muscles, joints, ligaments and organs, and it subconsciously decides which information you should really be paying attention to. Your subconscious usually makes good decisions, but it is very influenced by emotional factors like stress and anxiety. Your body is always creating new data for your brain, but your mood and personality will strongly impact what you do or don’t attend to mentally. Pain is a good example of this phenomenon, but it takes a bit more groundwork to explain why this doesn’t just mean that pain is “all in your head.”
Your ability to experience pain is an important evolutionary trait that helps your brain determine what is or isn’t safe for your body. You can sense when something is too hot and may risk damaging your skin, when something is too sharp that it may cut you or if an object is putting too much pressure on you that it could injure tissues. You live in a busy environment that requires you to sense, react and move in response to the forces around you and within you. Your body will create a homeostatic resting state that becomes what you experience as your ‘normal,’ and you need to be able to sense when things fall outside of that normal so you can take action to help keep yourself healthy. Pain is one of the signals that something is not normal, just like fever, altered heart rate, pins and needles, blurry vision, or a change in your balance. Sometimes your normal might change significantly, all of a sudden, but it also may change slowly and subtly over time. Your health and wellness are contingent on you paying attention to your normal and trying to understand why things may be changing.
It is easier to understand Why Things Hurt if you have an acute injury, but harder to wrap your brain around when your normal insidiously gets worse for no particular reason. It is important to appreciate that a lot of factors go into creating your normal homeostatic state, so it is unlikely that what you are experiencing now is a product of just one structure, event or system in your body. How you are feeling and thinking right now is the result of everything that you have experienced from birth to this very moment and is strongly impacted by the genetics your parents so generously passed on to you. Genetics may have provided you with a very resilient body, but life may have provided you with an abusive father, or a relentless bully that created deep-seeded anxieties in your personality from a young age. Conversely, you may have had an incredibly loving and supportive childhood, but developed diabetes or cystic fibrosis that forced you into the medical system at a young age. Everything you experience molds how your brain wires itself, affects how you think and impacts how you feel. Your nervous system is a complex, dynamic network that connects every part of your body and provides a two-way feedback system between your brain and your body to allow you to react to the world around you.
Think of your nervous system as an electrical grid that has a certain number of amps running through it. It likely functions well within a certain range, but if something or someone pushes it to its upper or lower limit, your body will start to react in negative ways. Think about how coffee affects how your body feels. If you are a coffee drinker you likely have figured out certain parameters around how many coffees in a day make you feel good, how many is too much and likely how much is too little. Caffeine is a legal drug that will impact your physiology and impact your nervous system, which we all know can become a very addicting experience.
The ability to control how you feel with very little personal effort is the root problem of society’s drug and obesity problems. We have commercially made available an endless array of pills, drinks, foods and substances that can help us escape reality and ignore the warning signs that our bodies are trying to communicate to us.
Stress has a big impact on your nervous system. Different people experience stress in different ways, some wear it on their sleeve and exude anxiety while others internalize and appear calm and collected while their body becomes a ball of tension (some will fall into both categories). Emotional stress raises the number of amps running through your nervous system and tends to create hypersensitivities in your body. Your nerves are the electrical wiring of your muscles, so hypersensitivity of your nervous system will commonly create localized areas of increased tone in groups of muscles in your body. Different people hold tension in different areas of their body, but you will commonly see tight bands of muscles in peoples’ necks, jaws and hips that are directly correlated to their subconscious emotional regulation. A person’s capacity for emotional intelligence will depend on their upbringing, their genetics, their age and their current environment. Most people will have some weak link or stress triggers that challenge their mental fortitude and will typically result in a physical manifestation of their cognitive problems.
Random life events like physical accidents can and do impact your nervous system. It is particularly vulnerable to axial loads of your spine like falling on your tail bone or landing on your head and it has a very hard time with whiplash forces that jar your neck around. Acute injuries can create structural damage in the tissues of your body, but the more time that passes after your accident, the less and less likely your pain is related to a damaged physical structure and the more likely it is related to a hypersensitivity of your nervous system. Your brain and your body can get overly reactive to certain stimuluses and start to misinterpret simple sensory feedback as a noxious stimulus and create unnecessary protective guarding in an area. Sometimes physical, mechanical stimuluses will trigger pain and sometimes simple life events will set off a generalized myofascial pain and guarding. A good example is the stress that people feel while driving even years after they have been in a car accident. The memory of what happened to them is often enough to set off some element of pain when they are in the car. I personally, am now quite sensitive to anyone getting their hand close to my face ever since I injured my eye. Our brains and our bodies remember what has happened to us in the past and those experiences shape how we react going forward. Part of controlling chronic pain is learning to accept the negative things that have happened to you in the past and not let them define you moving forward.
Pain is a perception. It is real, but it is not a tangible thing. Medicine holds the capacity to make you not feel pain temporarily, but you hold the capacity to control how you feel in the long run. Feeling good and being healthy require effort, attention, knowledge and persistence. You will need help to overcome obstacles throughout your life and you will need to open your mind to the idea that your cognitive and physical states are intimately connected, so in order to help one you will likely have to address the other.
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Brent Stevenson, Registered Physiotherapist@whythingshurt