B R A I N P A I N
‘Ouch. My back hurts. It must be my L4/5 disc again. It started 10 years ago, but it STILL really hurts.’
A common thought many have when it comes to back pain. But, when you feel pain does it really mean there is still damage? Can you still feel a disc bulge 10years later? No. Not exactly.
Chronic pain is defined as ‘pain persisting more than 3months’. Given that 80% of Australians get low back pain at some point in their life, it is not surprising that 1 in five Australians live with chronic pain.
When you get your first episode of back pain, its true that some of the pain generated can be coming the disc tissue itself. Our vertebral discs are like cushions between bones that make up our spine (vertebral bodies). They have high amounts of nerves, meaning they are very sensitive. However did you know that the generated pressure it takes to create a bulge is impossible to do from one incident alone? It is common to hear “I just sneezed and slipped a disc” or “I bent over to pick up my grandchild and my disc bulged”But in reality,it usually takes hundreds of thousands of repetitive movements to make a disc cranky.
When a vertebral disc gets cranky, it hurts. A lot. It can also produce pain and symptoms referring down the leg – pins, needles and numbness. This pain is intense and often unforgettable, and might sound familiar for many! These symptoms often last for 6 weeks or more. But if they persist longer than three months, research into chronic pain shows that the initial disc tissue damage is no longer the pain generator. The pain you experience becomes so much more complex and can result from changes that occur in your nervous system, your immune system and even in your brain.
NeuRA - Neuroscience Research Australia have found that people with chronic pain have changes in their brain - anatomically, functionally and biochemically… That’s a pretty scary thought for some of us, so what does it mean?
People with ongoing pain start to fear movements that will cause pain. They begin to worry about their pain a lot of the time. This fear and worry then makes the nervous system becomes sensitive. Think of it a bit like a volume speaker on a stereo system. The brain starts to turn the volume up to that region of the body - amplifying tissue nerve impulses, and then pain comes on with less provocation. When the disc was cranky, sitting was painful. The brain remembers that sitting was a problem and even once the disc is no longer cranky, the brain and the sensitised nervous system send messages that sitting is potentially dangerous.
Not only does the region of the body become more sensitive and hurt more easily, ours emotions and cognitions can be amplified. People with chronic back pain are more susceptible to depression or emotion changes and poor sleep.
Where does this leave us if we have had pain for a long time? 20years perhaps on and off?
The good news - our brain changes! It is an incredibly complex, but ever changing organ. It takes up to 20% of our energy to just keep it functioning. Every day that we breathe and move and think, our brain is learning and changing. And you are never too old for these changes to occur!
So with education, knowledge, posture, movement and strength, our brains sensitisation is reversible. There is constant proof of this not only here at Physiocise, but also by the brilliant research scientists into chronic pain - noigroup !
With the right advice and a little bit of help to get moving, you can be well on your way to changing your brain and your pain!
Want to read more? From the ABC ‘what chronic pain does to the brain’.