Haims: Hurting doesn’t have to mean harm
Pain is more than just an unpleasant sensation that can be irritating or even self-debilitating. Pain can also have emotional and psychological effects. By understanding how the nervous system works, in some cases we may be able to moderate how our central nervous system reacts to pain warning signals.
In this third installment of pain chronicles, I’ll speak with Dr. Elie Sabins, physical therapist and pain therapy specialist at Howard Head Sports Medicine, to find out how our understanding of pain can aid in rehabilitation.
Haims: What advice would you give to someone who feels like their pain is preventing them from doing the things they love like walking, hiking, skiing, etc.? ?
Sabines: If someone has persistent pain that is affecting their ability to do the things they love, there is still hope that it might change. When we remember that persistent pain may not be due to tissue damage but rather to an extra-sensitive and protective nervous system, we can begin to make changes to our bodies. It is possible to be sore and safe. Injuring does not necessarily mean harm.
Let’s say when you were watching the Olympics this year, curling looked like fun, so you decided to give it a try. But how are you going to learn? You can’t expect to get good just by watching other curlers. You need to find some curling shoes and start trying yourself out. Your first few times can make you very sore and tired, but over time as you keep working it gets easier. Our nerves work the same way. When we begin to return to our activities, by easing the pain, we can slowly desensitize these nerves and calm them down. But to get there, you have to accept feeling a little discomfort, knowing that it will eventually get better.
Conversely, if you were going to start curling for the first time, you probably wouldn’t be in an all-day tournament on Day 1. It takes time to practice and let your body adapt. to different activities. Unsurprisingly, our nerves react the same way. If we go through the pain and go from 0 to 100, your nervous system will most likely react in ways to protect you even more. This can contribute to people needing several days of recovery after doing something like curling and not having the best experience. We must therefore respect pain, but not fear it. Touch it, push it, then step back. And remember – you can be sore but safe, and pain doesn’t mean bad.
Haims: Besides simply inhibiting physical movement, what other ways does pain affect people?
Sabins: One of the reasons it’s so important for us to understand pain is that when we feel it all the time, it can affect every aspect of our lives. Have you ever listened to a song and it immediately brought back a memory? Maybe “Time after Time” will take you back to your high school prom and you can see your outfit, re-enact those awesome dance moves, and maybe even smell your date’s overpowering cologne. Or “Brown Eyed Girl” takes you back to a 4th of July picnic growing up. You can almost taste this hot dog and might feel a little nostalgic for those carefree days.
We now know that during this process all the different centers of our brain are used together to give you this experience. The parts that deal with emotions, memory, smell, taste, movement, etc. are all used together. And I’m sure you can guess where I’m coming from, but pain works the same way. While we feel pain, all parts of our brain are involved in processing it. When the brain is constantly bombarded with pain, past experiences and beliefs surrounding pain, it has less and less room for other things in life.
So you may be on an emotional roller coaster, you start to forget things, it’s hard to concentrate, or you may even have hot flashes because your body temperature center is also distracted. This is how the pain spreads to all parts of your life – your work, your hobbies, your mood and your relationships.
But the good news is that this can change. With more understanding, your nervous system and brain may become less concerned. As the perceived threat lessens, the pain may subside and all the parts of your brain that were busy processing the pain can resume their normal tasks. Then they can focus 100% on what they were supposed to do. In our last and final piece in this series, we’ll talk more about what you can do from here to lead your most fulfilling and meaningful life.
Over the past two months, Judson Haims, the owner of Visiting Angels, has spoken with physical therapists Doug Emerson and Elie Sabins to learn how new pain research is being integrated into physical therapy practices at Howard Head Sports Medicine.