Pain isn’t a pain to explain: Simplifying a complex topic for patients
It is estimated that 11.2 percent of American adults (25.3 million people) have experienced some form of pain every day for the past three months. If we extrapolate these numbers to include Canada we can infer that every citizen knows someone either in their family, circle of friends, or co-workers that suffer from chronic pain.
Learn to simplify
Chronic pain is a difficult topic to understand. Therefore, it makes it an even tougher subject to explain to patients – but it doesn’t have to be. Albert Einstein said: “If you cannot explain it simply, you do not know it well enough.” Now, in my 20 years of clinical practice, I have made it a priority to explain concepts in simple terms that my patients can understand. Simple explanations reduce patient anxiety and improve patient outcomes. All of which improve our business practice.
Sensory pain, emotional pain, cognitive pain
When we hit our hand with a hammer or stub our toe – the pain message travels from the area of injury to the area of the brain which makes us aware and conscious of the sensory pain. This part of the brain is called the pre-frontal cortex. At the same time another part of the brain called the limbic system, processes the unconscious emotions we feel about the pain and actually compares the pain to every instance of pain we have felt throughout our lives. This is called emotional pain. By doing this the limbic system actually amplifies the pain we are feeling and makes it even worse by adding anxiety and/or depression to what we feel.
The longer the pain lasts, the more the limbic system makes the pain worse until it’s chronic. At this point, movements that shouldn’t be painful – become very painful which causes the pre-frontal cortex to ask ourselves several questions like: When will this pain go away? Will I be like this for my whole life? How will I be able to babysit my grandchildren?
The answers to these questions get processed once again in the pre-frontal cortex and this makes the pain turn into suffering. This is called cognitive pain. Patients need to realize that the tools for recovery are closer than they think. Opiates and heavy pain medication only try to relieve the cognitive pain and the suffering of a chronic injury. Being autonomous and using mind-body medicine, we can help them transform the pain experience.
How to change the brain
In chronic pain, the sensory, emotional, and cognitive pain team up to change the structure of the brain – the process of neuroplasticity.
However, over the last 10 years there have been over 1,000 studies published about how mind-body medicine like mindfulness meditation and yoga can actually use neuroplasticity to change the structure of the brain to increase the amount of neural connections in the pre-frontal cortex. Eventually, the more we use mind-body medicine, the greater the chance that chronic pain is totally abolished.
Mindfulness meditation: This is the process of spending time in quiet thought. The best way to do this yourself is to go to YouTube and type in guided mindfulness meditation and find a video you like. Then find a comfortable chair, and quiet room, and close your eyes and gently breath deeply and slowly while your follow the voice of the guide on the video. Do this 20 minutes per day and focus on your breathing and allowing your thoughts to come and go freely without paying attention to them.
Yoga: Yoga is effective by yourself or in a group. This incorporates meditation and deep breathing but adds a physical component which helps improve the flexibility of your muscular system, normalize your fight/flight nervous system and improve sleep.
Acupuncture:Acupuncture or electroacupuncture have been shown in research and in clinical application to reduce the pain experience via a myriad of mechanisms. Acupuncture can normalize brain structure and function by stimulating the secretion of beta-endorphins and enkephalins in the brain and spinal cord. The release of these natural pain killers neuromodulates the pain experience. Acupuncture also stimulates the release of chemicals like norepinephrine, acetylcholine and several types of opioids which decrease tight muscles, improves sleep, and regulates appetite.
Anthony LOMBARDI, DC, is a private consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic, a multidisciplinary clinic. He teaches his fundamental EXSTORE Assessment System and practice building workshops to various health professionals. For more information, visit www.exstore.ca.
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