What is chronic pain?
“Pain is like a conversation between body and brain. But as in any conversation, sometimes there are misunderstandings.” - Alan Gordon
Pain is our body’s alarm system. It serves as a critical protective mechanism that lets the body know something is wrong, prompting us to act to avoid or address injury. Acute, or short-term, pain is adaptive because it makes us pay attention to potentially dangerous situations. For example, if you accidentally touch a hot stove, the sharp pain you feel immediately tells you to pull your hand away to avoid a burn. This type of pain is time-limited, diminishes with healing, and the cause usually is known.
Chronic pain, on the other hand, is pain that persists beyond the expected time of healing, typically defined as longer than 3 months duration. Chronic pain continues even after the injury or illness that caused it has healed or gone away. Some people suffer from chronic pain even when there is no past injury or apparent body damage, often following a stressful event. With chronic pain, while it may feel identical to acute pain, it is much more complex. It acts differently, responds to treatment differently, and even involves different parts of the brain.
To understand why pain becomes chronic, we need to look at how pain is processed. When you get hurt, special nerve endings in the body send pain signals to your spinal cord and up to your brain. Your brain processes these signals, telling you where the pain is and the severity of it. The brain then sends signals back down the spinal cord to the body in order to react (e.g. pulling your hand away from that hot stove). This all happens in the span of milliseconds. Before you have conscious awareness of what’s happening, your brain is already telling you what to do to prevent further damage.
When this system is working properly, it can save us from serious injury. However, this system also has the potential to malfunction. When the brain experiences pain over and over, it becomes more sensitive to pain. If our brain gets too good at experiencing pain, the condition can become chronic. Basically, your brain can unintentionally learn how to be in pain.
It is important to note that while all pain is processed in the brain, this does not mean it is “all in your head”! All pain is real, and chronic pain has real consequences. Nearly 1 in 5 people in Canada live with chronic pain, many of whom report it adversely affects some or most of their daily activities. However, because all pain is processed in the brain, we have the power to modify the quality and intensity of our pain. By addressing the physical, psychological, and environmental factors that influence pain, it is possible to teach the brain that you are not in danger, and to experience less pain.
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References:
Gordon, A. (2021). The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain. Avery.
https://www.canada.ca/en/public-health/services/diseases/chronic-pain/about-chronic-pain.html
https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force.html