Pain… What is it?

Tissue damage. Communication. Pain?

Remember that back injury you had a few years ago? The one that left you in bed for three days, moving in slow motion for a week. The one that still “twinges” every few months and lets you know its still there to ruin your day. Yet gradually you did recover. So what is it?

It’s probably not even damaged. But your nervous system remembers.

Your nervous system is lazy. It doesn’t want to spend energy to let you know your back hurts because of an injury you had all those years ago. You don’t have a bad back, you have a communication issue. Your body tissues heal themselves, almost always within 3 months. 

Go back to when you first hurt your back. Lifting, twisting, just woke up one day and couldn’t move, whatever. The first 3 days is the worst. Swollen, red, hot, painful. Scary. 

Within a week you have most of your movement back, though it still hurts. The body starts to heal as soon as it becomes injured. Within three-six weeks you’re back to a relatively normal life. You’re probably still taking paracetamol or anti-inflammatories (a story for another time).

Three months have passed and you’re back to 100% functionality. Apart from that occasional twinge you’re good as gold and back to exercising and having a life. Do you have a bad back now? No.

During the injury, your nervous system went into protection mode. This helps us stop further damage. Say you’ve overstretched a ligament – the surrounding nerves communicate pain to stop you further overstretching it. Helpful. It’s the same process whether you’ve rolled an ankle or “jarred” your back.

These same nerve pathways between your back and brain get lazy, another word for central sensitisation. Basically, nerves need input to send a pain message to the brain. At the time of injury, you feel pain because pain nerves are getting input. Lots of it.

Three months later it's healed. Done. No pain for nervous system input. Yet it still hurts?

 You have gone through central sensitisation (lazy nerves). Those same nerves that created pain at the time of injury keep telling you there’s damage in your back. There’s not. This is the simplified basis of chronic pain. It sucks.

Same pain, no damage, no injury. No sense. 

So, what can we do about it?

I find most of the time the most important factor is simply being told its not forever. There is almost always light at the end of the tunnel. It’s a journey. Your body works hard to get better and your osteopath knows this. When the wires in your brain hear that, they take a big breath. Imagine the impact of your first big breath after years of shallow breaths.

That’s what we do. Find and show the reason for continuing pain, address maintaining biomechanical factors, help your body de-sensitise the affected nerve pathway, relax the nervous system and of course stick an elbow into your glutes while we’re there.

This day and age there’s no one pill fix all cure for back pain. Its mostly trial and error. This is all we have for now, but it works.