Almost everyone that I see is dealing with pain of some form. Some present as acute but the most common is chronic. A lot of chronic pain sufferers come with a history of motor vehicle accidents, osteoarthritis, spinal stenosis, fibromyalgia, or recovery from a total hip or knee replacement. In my experience, there appears to be two components of chronic pain that must be dealt with in the kinesiology model:
1) Address the pain by prescribing movements that will improve strength and range of motion to correct the pain, specifically that speaks to the cause of the pain.
2) Address the guarding and accommodation that has not only resulted from the pain but is perpetuating more pain.
The second item listed is the one I will focus on in this post. Number two is often the barrier from moving forward into progress; the ball and chain that is keeping someone in their pain state. It goes beyond the physical injury or trauma that may have initially occurred to create the pain. It’s a behavioral state that has both conscious and unconscious aspects. Moving past this barrier is by far the most difficult task in dealing with clients as no two people are the same in how they recover from chronic pain. Some of the overall behaviours are common among individuals but the way to intercept is different with each person.
If you deal with chronic pain, know this:
1) Your pain is real
2) Your pain is treatable- often through movement
No one, these days, needs to be convinced that exercise is good for you. The information available is overwhelming. Weight loss, cardiovascular, strength, conditioning- all results of a consistent exercise regime. However, what is it about exercise that addresses pain? We know that it helps alleviate pain, but why? How?
Brain and Behavior
In the last 20 years, there has been some excellent research on the topic of the brain and the nervous system. The last 10 years has resulted in a very steep learning curve for researchers and professionals in the understanding of our behaviours, our bodies, and particularly our pain. Studies are determining that rather than focusing on the exchanges of messages in the brain to explain pain, the brain can be geographically mapped with the physical parts of the body in a particular geographical region. These regions receive stimulus in and can transmit stimulus away. Applying a stimulus of touch to the lower leg will result in the “lower leg region” of the brain map to light up and respond. Continual stimulus of that region will result in a refinement of the neurological route or highway that the incoming stimulus travels on. That route becomes a very efficient, well-oiled machine. When our brain regions receive such a strong, efficient input over and over, they look at nearby regions that are receiving less stimulus and move in on their air time. Yes, if the lower leg region is getting a great deal of incoming message, it will look at the knee or ankle and move into it. In other words, the message “spills over”. What does this result in? The perceived pain will travel from the lower leg of the person and “refer” to the upper or lower regions around that physical area. This re-mapping that happens on a high center in the neurological chain has helped explain referred pain and phantom limb pain. I think it sheds a huge amount of light on chronic pain. Especially in cases where the original injury has long healed but pain in the region or other regions persists.
Now, let’s consider other regions of the brain- we’ve got areas for mood, emotions, impulses, urges, hunger, and sleep. For the chronic pain sufferer, the signals are so strong and efficient that they can influence these other regions. Pain signals from the body can become pain in others aspects of wellbeing like emotions (e.g. depression) or disrupted sleep. This signal can play out in the reverse effect as well. Studies have shown that emotional pain can translate to physical pain; a region of the brain map can become so efficient with stimulation that it begins to be opportunistic and take over the brain tissue occupying or representing a physical part of the body such as the back or the shoulders.
What does this tell us? Our nervous system is trainable. Our nervous system is adaptable. Yes, pain can be trained in very easily; BUT, it can also be trained out!
Stay Tuned for part 2, which dives into how Kinesiology can train your pain away.