Many factors influence persistent pain

Woman hip

Whether it’s from a broken arm after coming off a bike, stepping on a dreaded piece of your kids’ Lego or an arthritic hip that keeps you up at night, pain is something we are all familiar with. Pain can be fleeting but sometimes it persists for much longer. A stubbed toe may have us making deposits in the swear jar but given time that pain will go, and we carry on with the rest of the day without giving that toe a second thought. But what about the back pain that’s been hanging around for weeks or months? We’ve bought a new chair to help with working from home, we’ve tried paracetamol and even Aunt Linda’s heat pack that she swears by, but it’s still niggling away. This is worrying. Why won’t it go away? Will it get worse? Is this how my back will be from now on?

Here, Miriam Daurat, Chartered Physiotherapist at Our Health Hub, discusses the value of recognising the many factors which influence pain:

  • Our brain conceptualises pain in different ways. It builds a picture from personal information such as where the pain is coming from, how severe it feels, whether it is getting worse/better/staying the same, and what we have been doing that could be the cause. It compares that information to past experiences of pain. If we have previously needed medical intervention then things like our care experience, and length of recovery will also factor into how our brain rationalises how to process our current pain and expectations of outcomes.
  • The experiences of friends and family also influence how we feel about pain. Hearing about Cousin Larry and how his knee was never right after a nasty football injury as a teenager can have a knock-on effect if you start getting pain in your knees. This can go either way. If cousin Larry has managed to lead a pretty normal life following surgery, physiotherapy, or with a good pain medication regime, then it stands to reason that our brain figures that some knee pain is going to be manageable. If his experience is that no one helped him with his recovery, nobody took his pain seriously and that the pain is the root cause of all his life’s misery, then you may feel panicked if you start having pain in your knees.
  • Pain can be frightening, whether it’s a random and unexpected sharp pain or a longer-term constant/intermittent pain. I’m hurting and I don’t know how or when it will stop. Could something bad be happening to me? This is where we need to take a step back. A big step back. Take a breath, try to relax a little!
  • A good start can be thinking about our breathing and encouraging normal movement. An all-too-common response to pain is to hold your breath or to take smaller shallower breaths. However, it is usually beneficial to do the complete opposite. Taking slow deep breaths can trigger the part of our nervous system that helps us feel relaxed, slows the heart rate down and allows muscles to feel less tense. Sounds good, right? If we can feel less stressed about pain then we can move better, which in turn encourages us to move more. Keeping activity levels up means promoting strength and flexibility in the body which releases feel-good endorphins that reduce pain perception as well as easing joint and muscular stiffness.

The journey of learning how best to manage pain is one of many steps. Understanding how to get in a good mindset is one of the kindest things we can do for ourselves. Even though lots of things contribute to pain, there is always something new to try or another way to approach challenges.