Pain Neuroscience and Why It Matters to You
Welcome to Physical Therapy month!
The profession of physical therapy is diverse and helps people to achieve their physical goals by helping them overcome injuries, strengthen their muscles, improve their balance and coordination, and significantly, address their pain. With a good understanding of pain, people can achieve their goals and live their best lives.
So what is pain? Pain is a response of your brain, and it be divided into either chronic pain or acute pain.
Acute pain occurs right after an injury and is due to inflammation and tissue damage. Pain receptors, special nerve endings embedded in the surrounding tissue, send a message to the brain alerting you that there has been an injury. This helps your body to respond properly so you can heal. You can think of the nerve receptors as a “gate” which opens to send a signal of pain to the brain. However, the degree to which the “gate” is open can be affected by the sensitivity of the nerves, which in turn is related to a wide range of other factors.
This becomes more evident with chronic pain. Although the tissue may not be damaged the nerves are hypersensitive (on “high alert”) and continue to send pain signals to the brain. Other factors can contribute to the hypersensitivity and “open to gate” further, causing the pain to become more intense. A good understanding of these factors can be beneficial in addressing pain and “closing the gate.”
The first approach to relieving pain is to address the mechanical aspects of the pain. For instance, massaging the painful area increases blood flow to bring nutrients and oxygen to the area for better healing. Additionally, deep pressure stimulates different nerves than the pain receptors, causing the brain to become overwhelmed with multiple signal and “closing the gate” for the pain receptors to send pain signals to the brain.
Another approach is to address psychological factors. Anxiety, depression, and fear put the brain and nervous system on “high alert,” which can make the nerves more sensitive and “open the gates” of the pain receptors. Addressing psychological factors by meeting with psychologists, learning stress management techniques, and joining a support group can help to address these underlying factors. The techniques learned from these resources can help to calm down your mind and nervous system, which will decrease the sensitivity of your pain receptors.
Nutrition is another important component which can affect pain intensity. Foods high in antioxidants, such as fruits and vegetables, green tea, garlic, and walnuts can promote healing and decrease inflammation, relieving the nerves. Conversely, foods with high oxidative properties such as well-cooked red meat, sugars, and refined carbohydrates can increase the body’ natural inflammation and further irritate nerves. A proper diet can have a large effect on your body’s sensitivity to pain.
The therapy team at JTOPS can help you to address your pain! Physical therapists can assist you with hands-on treatments to improve blood flow and teach strategies to modify movement patterns for reducing pain and stress on joints, and to loosen tight tissues. They can also help you to learn mental techniques such as deep breathing, mindfulness, and stress relief. Speech therapists can help you to be a self-advocate regarding your pain, and to better verbalize pain levels and determine strategies for organizing your timeline for reducing pain and strategizing to find additional resources. Occupational therapists can help you to determine methods for compensating for pain when performing functional activities. Together, we can help you to overcome pain and live your best life!
Gate Control Theory of Pain. American Psychological Association , https://www.apa.org/pubs/books/supplemental/integrated-behavioral-health-second-edition/GateControlTheoryofPainHandout.pdf. From “Integrated Behavioral Health, Second Edition”
Kirsten Williams-Mullin, PT, DPT