Chronic pain is the most lifestyle limiting and disturbing condition for the sufferer. And today, I'll tell you the two most important things to always remember if you have any chronic pain.
I need to tell you the basic principles first, what you need to do will then follow naturally.
There are three basic points.
First is local inflammation.
Inflammation is the swelling, redness and increase in temperature that you see after all injuries. This inflammation is due to release of special chemicals by the injured cells. These chemicals help in repair but also cause pain. This inflammation occurs in all injuries. Whether it is muscles, joints, bones, organs, spine, everywhere. This pain is protective. It will stop you from moving the injured part and cause more injury. But when it happens again and again, it will cause abnormal changes in the nerves and tissues that will increase the pain and disability.
The second point is nerve sensitization.
Let me give you some background about how pain differs from other senses. The other senses undergo sensory adaptation. You feel the chair when you sit on it, but then you forget about it within seconds. Similarly, you stop noticing a smell, sound or something in your vision, if these are not important. This is an adaptation, it frees up your concentration from unimportant things.
But pain is different. There is harm if you stop noticing it. That is why our nervous system has evolved to gradually notice it more, not less. The pain keeps increasing with time, to force us to do something about it.
The way this increase in pain perception occurs is by increasing the sensitivity of the nervous system to pain. Both the peripheral and central nervous system becomes sensitized. The peripheral nervous system means the nerves that carry pain sensation to the brain. They become more sensitive. The central sensitization is a change in brain synapses that leads to increased perception of pain and increased suffering with pain.
Now, the third important thing is strengthening.
Muscles, bones, ligaments, tendons, lose strength if not stressed. Which basically means that not moving a body part will make the supporting tissues weaker. And once the supporting tissues become weak the pressure is more on the painful part, leading to more pain.
So, let us come to the 2 rules with this background knowledge.
Rule number 1
Avoid everything that causes or increases your pain.
For example, working on a computer if the mouse or keyboard increases your wrist pain. Or walking if it increases your hip, knee or ankle pain, or playing racquet sports if it increases your shoulder or elbow pain. I'll tell you in future articles which activity needs to be stopped in which pain.
This holds true in visceral pains too. Visceral pain means pain of the organs, like stomach pain. Don't eat spicy foods or tea or coffee if these give you pain of gastritis.
See, your body is telling you through the language of pain to stop doing the painful activity.
Listen to it and respect it
Otherwise what will happen? Yes, you already know, repeated inflammation will not let that part heal and nerves in that area will get sensitized. This will make the pain more and more difficult to heal.
Does this mean that you should give complete rest to the painful part, you may ask!
The answer is no. And this is where rule number 2 comes in
Absolute rest for weeks to months will make the supporting structures like muscles and tendons weak. So you need to move the part. But how! Wouldn't it cause more pain?
And the answer is, do movements that are not painful. Do whole body exercises, avoiding the painful joint. Like upper body exercises in lower body pains and vice versa. This much is easy to understand. It can avoid the painful movements altogether. But how would exercising other parts help? Exercising releases hormones in the body which strengthens the musculoskeletal system. So exercising indirectly helps in maintaining even those muscles which are not exercised.
But the real exercise is of the painful part while still avoiding pain. These are the exercises which will strengthen the supporting structures, which will offload the stress on the painful part.
For example, in shoulder pains, there would be some movements which would not be painful. Or some movements would be painful at a certain angle but not always. Changing the angle a bit will avoid stressing the injured tissue. Do that. And do it with some resistance, like resistance bands or weights.
If walking is painful to the knee, do strengthening exercises with ankle weights, most of the times those are not painful.
Just avoid the painful movements but continue doing strengthening and you will see that even the most stubborn pain is getting lesser and lesser by the day!
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