There’s nothing more damaging to a human, a society, or a culture than a suitcase word. Something that is so big that you can throw everything in it with no approximation to control it.
Pain can be one of these concepts. It covers such an array of areas and has such a broad association of meanings that we don’t know how to deal with it. Yet when we see in most imaging studies that there is no correlation between pain and degree of tissue damage, we can look to our knowledge of the brain for greater insight.
When we look at different types of pain, we acknowledge both physical pain and psychological pain, and that either can become chronic. Looking at the biopsychosocial model can also help us to better understand our experience of pain, as we can see how hyper-integrated the system is and how everything is interwoven in the things that influence it.
Bear in mind, this is not meant as a diagnosis, but an overall view of what pain is and how the brain responds to it. It’s complicated, but this is meant as a helpful invitation to understand pain in a different way and, while it might not land for you as an individual, this is what we collectively understand of pain.
We must recognize that there are genetic prompts that influence pain. Yet, when we look at the factors that affect our genetic expression, we can see immediately how difficult it is to uncouple the psychological and social aspects, as we look at developmental patterns which form early in life.
The social element of our family culture plays an important role. If we are raised to understand pain as something from which there is recovery and has an endpoint, versus a catch-all term of pain that reflects an ongoing state, we have a better framework to begin.
When it comes to the role of the brain, ideally, we want to have positive experiences with movement and relationships in early childhood to set you up to be less reactive to pain. If we think of successful aging beginning in our 30s and 40s, successful interpretation, resiliency, and reaction to pain should start at a very young age.
In the absence of that, we may have a tendency from a psychological perspective to catastrophize pain, which tends to magnify degeneration as we move through life. For the part of the brain, we don’t want to centrally sensitize pain—that is to say that we don’t want it to become a core part of our being which governs everything else.
When pain becomes chronic, being able to project into the future to predict if it will get better is a skill which is predictive of recovery. Yet, if we did not have that template from early childhood, it becomes something that we must cultivate.
Benjamin Franklin said, “Those things that hurt, instruct.”
But, in order to understand the instructions, we need to understand our brain. And its primary functions are to predict and protect.
Pain is protection. It keeps us from doing the things that our brain perceives as dangerous. The brain doesn’t actually sense pain, it interprets data (based on your physiology, your memory, and your emotions) and it organizes a pain response.
In attempting to be predictive, we can become very hyper-vigilant in the presence of pain, like a smoke alarm that is very sensitive, and also very hyper-responsive to new things, whether they are good or bad. It is also in the desire to anticipate that we may become anxious about the recurrence of pain, which can be one of the most challenging parts of the rehabilitative process.
In addition to safety, the brain is also very concerned with conservation of energy through allocation of resources.
As a result, pain affects our working memory and decision-making capacity, so people with pain tend to lose confidence in their ability to make decisions. And while we may simply desire to feel better, we may not really have a sense of what that means.
It also likes to use old tracks and patterns. It is a clever system that allows it to bootstrap new things onto existing pathways; however, it can also make it challenging to form new habits in times of conservation.
To further save energy, we have a more limited capacity to understand new information when we are in pain as well, so a cautionary tale about the information your consume with regards to researching your symptoms. While it may feel helpful and empowering to know what is going on, it can also create a feedback loop that only drives the cycle.
Because the brain is also an amplifier. Any emotional, social, or general life conflict that we have intensifies this psychological aspect and amplifies the experience of physical pain, as our emotional and physiological state are the same. In this context, a practice of strategic awareness and consistent forgiveness is the antidote to the vicious cycle of shame and blame that we all have in common as human beings, regardless of pain.
We touched on the role of family and culture in how they affect the formation of our perception and experience of pain, and those continue to affect us throughout our lives. Our ideas of how we should deal with pain are also very society driven.
From a rehabilitation standpoint, there are multiple studies that demonstrate that the number one determinant of recovery post-knee surgery is social support, and I think this tends to be overlooked. In our more vulnerable times, we all need someone to help us up the stairs or get us a drink of water when we cannot do it for ourselves. People who boost our spirits and help give us hope are important.
While it is an area that we do not always have control over, it is worth noting how you are affected by the people you are surrounded by, and if they are contributing to the psychological elements we talked about.
Though biologically we are social creatures and are hard-wired for connection, it is also important to remember that you have to be the most important person on your team.
And while this all may seem like a lot to manage, there are things that you can do to help yourself in the day to day.
From a Brainfullness perspective, these are some tips for navigating pain:
• Practice feeling without story. Often the meaning that we give our pain only feeds the cycle of it.
• Incorporate purposeful movement that celebrates aliveness. You will experience less pain if you are lifting that suitcase to go visit your grandchildren as opposed to going to aquafit class.
• Optimize other aspects of health. Because any pain is such a total experience that there is that stacking effect, if you optimize other aspects of well-being, such as sleep or nutrition, you are able to have a positive effect.
• Don’t overcook it. Throughout evolution, pain was used as a signal to change behavior. Challenge your behavior without provoking your pain.
Knowing what your own goals are in terms of what you hope to optimize is a useful way to guide your course of action and what type of practitioner you are looking for to help you. In that way, we can divide the suitcase up into more manageable categories for your immediate practical usage. If you are looking to be preventative and minimize future risk, wanting to be pain-free or minimize pain at work, that may be a different process than seeing your pain as a window to your emotions.
But also know that the bias of the brain will always have us looking for the ‘silver bullet’, that is the magic pill or practitioner that will be the key; yet it is often the multi-disciplinary and multi-factorial approach that is most useful for pain.
There is a nuance and care to successfully navigating the puzzle of pain. It is important to know that, even though we have no control over the foundation we have and the magnitude of pain may seem overwhelming, we can still build a construct in which we can overcome it, and we can minimize the disability we may have during the process.
In looking at what pain is good for, it can bring us into the present moment and, like the brain, prioritize what is important. Health issues have a way of testing your resiliency and your perseverance, and they force you to have a reason to learn about yourself.
But it is also worth noting that people often make the mistake of thinking that when they are pain-free, they will ‘feel good’, and that is also a multi-faceted construct.
My aim is to not turn you into a fragilista by overwhelming you with information and prognoses. It is important that the interventions, whether in self-care or prescribed, are designed to have impact and to have the right dosage. Dealing with persistent pain can be challenging, but to be able to keep going is the main thing.
While it can be daunting to carry the suitcase alone, if you are looking for a practitioner to help you
build that framework with deliberate and efficient strategies, feel free to book an appointment.
I have designed Brainfullness to help you create a better interface between your brain and your body through your sensory system in order to have sovereignty in treating your pain. Through simple neurological resets you are generally more able to manage stress and handle life better. I will be offering 45 minute virtual appointments in which we will do an overall assessment of health, and personalize some moves and techniques to help you in a way that is user-friendly and fits your lifestyle.
Join us at our Virtual Launch Party on October 1st at 7pm here.
I look forward to seeing you online!
Click here to book an appointment.
Dr. Tabrizi is a chiropractor, osteopath and a passionate member of both the local and scientific community, whose goal is to teach that the pursuit of optimal health and wellness is much more than being symptom-free. His practice is rooted in the philosophy of treating the person rather than just treating the illness or ailment. As a result of his interdisciplinary training, Dr. Tabrizi has developed a neuroscience-based therapeutic education approach to treating his patients, focusing on healing illness from a wider perspective, placing equal responsibility on patient as well as practitioner. Dr. Tabrizi aims to educate his patients and provide them with the tools and framework needed to integrate pain management and healthy living into the fabric of their everyday lives.