Why Does Acute Pain Turn Into Chronic Pain?

Why is my pain not going away? My friend or family member got better so much faster than I did! We had the same injury! Everyone experiences pain differently, and there are many factors that play into how you experience pain.

Pain is Not the Enemy

Pain is present in our bodies in order to protect us. If you stepped on a rusty nail, would you want to know about it? Of course! You need to know you stepped on a rusty nail so you can remove the nail, clean your wound, and get a tetanus shot so worse things don’t happen. Pain is our body’s way of letting us know something is wrong so we can do something about it.

Nervous System = Alarm System

Our nervous system is our body’s alarm system and tells us that something is painful. It’s like a house alarm. When the nervous system perceives a threat (stepping on a rusty nail), the alarm is activated (pain). Once the threat is removed, the tissues heal and the alarm turns off.

chronic pain

The Sensitive Nervous System

The alarm does not easily turn off in 1 out of every 4 people. In these individuals, the alarm system (nervous system) continues to stay activated, and over time it becomes sensitive. This is like a house alarm going off when a branch touches the roof or a leaf blows against the window. It now does not take much to activate that alarm. Activities or movements that once were not painful are now painful. Acute pain is now chronic pain.

chronic pain
Many things can contribute to the alarm system becoming sensitive and turn acute pain into chronic pain:

  • The environment in which pain began (car accident, fall, injury during sports)
  • Emotions (anxiety, depression, fear, stress)
  • Failed treatments in the past or conflicting diagnoses
  • Family issues (overprotective, unsupportive)
  • Work issues (extended time off of work, concern about pay)
  • Behaviors (excessive alcohol intake, smoking, excessive rest, poor diet)

There is a study that looked at how the environment impacts the pain experience. The researchers looked at how many demolition derby drivers had neck pain compared to the general public. They found that 1 out of every 40 demolition derby drivers had neck pain. In the general public, 1 out of every 3 people end up with neck pain after a car accident. Why was there such a big difference in those 2 groups of people? One group of people (demolition derby drivers) crash their cars for fun. The other group of people (the general public) is not expecting the car accident, and it’s often a very scary situation.

The Alarm System Can Be Turned Down Again!

Even if you have chronic pain and a sensitive alarm system, it can be calmed down again. There are 4 important activities that you must do in order to calm your nervous system back down.

1. Learn more about chronic pain

You’re doing this now by reading this blog post! Understanding more about what factors play into your chronic pain can help you gain more control over your pain.

2. Get good quality and quantity sleep

Sleep is when our body recovers from the day and gets ready for the next day. It’s important to get enough sleep in order for this to occur.

3. Aerobic exercise

Endorphins released during aerobic exercise can decrease pain and calm your nervous system. All you need is at least 10 minutes of aerobic exercise for that endorphin release. Pick your favorite form of aerobic exercise!

4. Set goals for yourself

Create functional goals for yourself and slowly make those goals larger over time. It’s ok to flirt with the pain, but don’t date it. Set a goal for yourself in which you experience a little increase in pain that goes away easily (flirting with the pain). As you push your limits, over time you’ll be able to do more and more until you reach your long term goals.

See a Physical Therapist Who Understands Chronic Pain

During physical therapy we address turning down your alarm system, as well as addressing your pain through manual work and exercises. If you’re experiencing chronic pain, it’s important that your treatment not only addresses your tight muscles, weak muscles, etc., but it also must address your sensitive nervous system. There are many other techniques to calm your nervous system that can be individualized based on your specific pain experience.
Images were taken from Explain Pain by David Butler and Lorimer Moseley.

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