Chronic pain is generally defined as ongoing pain lasting longer than 6-12 weeks. This type of pain can be hard to treat as it has lots of layers and is not just a primary injury or pain point.
There are four layers of pain: physiological, neurological, psychological and biomechanical. The physiological layer is when the body’s healing process doesn’t know when enough is enough. An example of this is chronic swelling or inflammation. The neurological layer is where the brain interrupts signals such as a stretch or pressure and mistakes it for pain. The psychological layer is when someone changes their behaviour patterns because of fear or apprehension about the pain. You might know this from when you avoid household chores or particular activities because of a concern about it triggering pain. The final layer is biomechanical. This is when your behaviour is compensated from living with the pain or injury; an example might be walking with a limp.
To treat this pain we take a multi-faceted approach with three main parts:
1. Passive recovery (my job) – treatment based therapy to relieve pain and symptoms and restore function. Pain relief is usually an anti inflammatory medicine (NSAIDS) which is managed by a GP.
2. Active recovery (your job) – stretching for relief and flexibility, and rehabilitation exercises.
3.Re-education (the hard bit!) – this includes posture management, pain management including what you do when your pain increases for short periods of time, how to exercise with pain and when to exercise, returning to activities and goal setting. It’s also about learning how to manage your fear of the pain and understand why you avoid certain activities.
The third point is the hardest as it makes you look at a lot more than just the physical pain. The time it takes to get back to full function without pain can vary and depends on factors such as age, weight, time with injury, and how compliant you are.
One of the first steps is saying you don’t want to live with the pain anymore and then making the decision to become proactive towards your symptoms. It goes without saying, making an appointment to see your myotherapist is a great step on the road to recovery.
– Tom McLeod
