Pain is a very effective alarm system that functions to warn the body of damage or potential damage and to promote healing by limiting movement of the effected area. It is a combination of sensory – the touch part (eg cutting, crushing, burning), and emotional (the unpleasantness of pain) factors, and is controlled by the nervous system locally with strong influence from the brain.
We learned that acute pain is now well managed within the medical world and follows a generally predictable pathway from injury to healing which lasts up to 4-6 weeks. However, around 520,000 kiwis suffer from persistent or chronic pain which is similar to a ‘magnified’ alarm system where there is a very poor correlation between pain and tissue damage. In this situation the pain is not signaling further damage and does not serve as a protective role as acute pain does.
Pain also affects muscles and movements in a very complex way involving the brain, spinal cord and local nervous system responses including:
Muscles may shut down very rapidly following injury, resulting in imbalances which create a vicious cycle of movement pattern disorder and ongoing pain.
‘Fear avoidance’ of movement due to pain has been shown to predict increased levels of pain the following day in a recent Danish study – showing the need to keep moving when in pain.
We help people in chronic pain by starting with a comprehensive assessment to identify factors contributing to the pain process including structural issues, muscle imbalance and weakness, and areas of myofascial irritation. This is followed by an intervention with a targeted corrective exercise programme which focuses on addressing the issues identified, along with expert supervision to ensure the programme is carried out appropriately.
Richard Trendle MSc, Exercise Physiologist