Have you been told that your pain is “all in your head?”
Did you find this deeply offensive?
Did it feel as though you were being told that your pain isn’t ‘real'?
Did it make you think the person who said it really didn’t really understand your problem?
Addressing the injury, along with the causative factors, is vitally important when dealing with pain. It is crucial we don’t forget that!
This article aims to explore pain science by comparing it with vision; another sense that is no different to our sense of pain in terms of stimulus integrating with brain connections before it results in the experience we are all familiar with.
“The lens is as important as the light”
This is a quote from ‘The Broken Eye’ by Brent Weeks. He uses this quote as a way of explaining that what we see is influenced by our interpretation of the event.
Have you ever heard two people give very different accounts of the same story? We all have! We see what is relevant to us and we use our understanding of the world to make sense of it. Therefore, what we think is happening is influenced by where we are directing our focus.
This video highlights how much we do this:
This can be applied to our pain experience as well.
When we are worried about an injury and how it is going to affect our lives, we focus on the pain and it becomes more obvious. When we see scary medical reports describing our injury, our focus becomes more acute so we feel every little movement occurring in that area of our body.
So…
Vision is more acute when we focus more specifically.
Just like pain.
What other similarities can we make between to two?
Vision provides meaningful information which we use to preserve our wellbeing.
Just like pain.
Vision is the result of millions of connections within the brain.
Just like pain.
The experience is influenced by your perception and understanding of the event.
Just like pain.
What you see is real!
Just like pain!
Just because our brain plays a major role in our visual experience, doesn’t mean the objects we see aren’t real.
Just because the brain plays a major role in pain perception, doesn’t mean
you’re making it up.
Is what we see an exact representation of what's occurring?
Light receptors on the back of your eye detect the light which reflects off objects and trigger nerve signals towards the brain. Your brain gathers that information and interprets what it means by making millions of connections with other brain centres.
Humans have 3 types of cones (colour detectors) in our eyes; red, blue, and green.
Then how do we see yellow?
This results from the green and red cones being stimulated while the blue cones have no stimulation. It is the overlap of the cones and how the brain integrates the signals sent from these cones which allows us to see millions of colours.
A mantis shrimp has 16 types of cones, including ultraviolet. In fact, this little guy has such good eyes, he can even polarize light. No expensive polarized glasses for the mantis shrimp!
In fact, a lot of the animal kingdom has far more refined eyes than our own. We make up for this with our oversized brain, which is especially good at interpreting information and combining it with past experience and knowledge to give it meaning.
Would you believe me if I told you these two tabletops are exactly the same size and shape?
If you don't believe me, watch this video:
Remember this?
This dress caused a social media divide so wide, it nearly split the nation.
If you don't remember it, note which two colours you think the dress is, then ask a friend.
Prepare yourself for an argument.
Some people will swear it's white and gold.
Others will swear it's blue and black.
And finally, an old favourite:
You simply won't believe me if I tell you that A and B are exactly the same colour/shade.
What you see is the pattern. It's a checkerboard right?
Therefore, A is darker than B!
Nope, they are exactly the same!
If you don't believe me, copy and paste the image on paint, cut them out and place them on the side
Like this:
To your brain, the pattern is what is most important.
Is what we see an exact representation of what's occurring?
Well, no, but it’s sufficient enough to allow us to interact safely within our surroundings.
Is what we feel in our body an exact representation of what's occurring?
Your body; your back, your knee, your hip, your ankle; doesn’t possess the entity of pain. Pain is not a thing that exists in your body. If it was, we wouldn’t have amputees report pain in a limb which is no longer there.
Like vision, special receptors detect sensory information, such as sharp, dull, hot and cold, or chemicals such as inflammation. These special receptors trigger signals to pass through the nerves to the spinal cord, which relay those signals to the brain.
The brain then interprets those signals, drawing information from about 500 other areas of the brain to provide a meaningful experience, which we perceive as pain. Pain needs to be terrible, because it needs to protect us from the potential for further damage.
But just like vision, the pain you feel requires meaning and is influenced by your knowledge of what’s occurring, how you feel about your body, as well as past experiences.
Take a second to think about how the thoughts below might therefore influence your pain experience:
- This is my ‘bad’ knee.
- My disc has slipped again.
- If I was a horse, you’d shoot me.
- I have the knees of an 80 year-old.
- That sharp feeling on my toe after I just put on a pair of gumboots, could be a spider biting me.
BUT WHAT DOES THIS MEAN FOR YOU?
There is nothing more frustrating than being told your pain is in your head. You know there is an issue in your body, AND THERE PROBABLY IS! Our pain system is well designed to protect us, so just because your brain plays a role in your pain experience, doesn’t mean there is nothing wrong with the area that hurts.
When your back is so painful you can’t do up your shoe laces…
When your neck is no sore you can barely check your blind spot…
When your knee is so sore you struggle to walk up a flight of stairs…
You want to know what adjustments you need to make to avoid straining to injured area.
You want your osteopath to consider how he could help alleviate your pain.
You want to know what you can do yourself to help the situation.
It’s all well and good that we understand pain is influenced by your perception of the issue, and we should have this discussion where appropriate, but it is a monumental error to let this take away from treatment and rehab 101.
So what should pain management look like in a clinical setting?
At YouMove Osteopathy in Mount Eliza, it looks like this;
Firstly, we listen to your problem and give you the time to explain how it’s effecting your life.
We perform a thorough assessment which allows us to provide a working diagnosis.
We help you identify the causative factors for your pain.
Manual treatment is utilised to help get you moving and feeling better.
This will encompass the techniques you are comfortable with and may include soft tissue techniques/massage, active release techniques, stretching, muscle energy techniques, joint mobilisation and manipulation, counter-strain techniques and myofascial dry needling.
We will prescribe exercises.
Exercises aim to correct any weaknesses or imbalances which may have been causative, or maintaining the problem.
We will educate you on your condition.
Education is empowering and may involve discussing lifestyle factors such as activity modulation, ergonomics, working posture, stress management and how to wisely progress the return to your chosen activity. And yes, we can also discuss pain science to help you better understand how your pain is influenced by perception.
If your osteopath can provide you with the information you need to understand your problem, this in itself is a very powerful tool when it comes to pain perception as it removes a lot of the fear and uncertainty surrounding your pain.
If you are in pain, and you're not finding the answers you're looking for, get in touch with YouMove Osteopathy in Mount Eliza. We'll do everything we can to help you with your condition.
