Friday, 8 January 2021

Retraining the brain around persistent pain.

There has been a great deal of research into pain in recent years; it is now much better understood that perception of pain, as in how much pain we feel, is mediated by the brain rather than the tissues. Many of you will have seen a short talk on pain, 'Why Things Hurt' by Professor Lorimer Moseley made back in 2011. Here is a recording of a more recent lecture by him that as well as explaining what is going on when we feel pain also explores (from 48 minutes in) how we can manage our pain and retrain our pain response.  


One of the things that I really like about how he talks about pain is that he emphasises that many of his patients with chronic, persistent pain are some of the bravest people you could meet. He understands that persistent pain can get us down, that we can begin to worry that people don't believe us or that they think we are 'weak', or we may begin to be frightened of what is happening with our body to create all this pain. This is why he is so keen to educate about pain and as well as watching the video I recommend having a look at the two websites linked to below. 

In summary:
Pain is there to protect us, but it can become oversensitised and turn from a useful tool to something that is controlling and restricting us.
It is influenced by context and meaning - past history/associations; our mood, fears, thoughts and health; our beliefs, knowledge, culture, social circle and so on (listed in the video).
Inflammation elevates the pain response.
Perception of pain can be dampened down by:
- understanding what is happening, and being shown understanding.
- having patience and persistence as retraining something that has developed to protect us will take time.
- having someone to support and coach you through the process.

He also emphasises that movement and activity is good especially once a safe baseline has been established to build from; not moving (where chronic pain often takes us) is not good. We need to retrain the brain that movement is safe - something that many movement therapies such as JEMS embrace.
My own journey with chronic pain turned a corner when I discovered two different yoga teachers, teaching very different types of yoga, who provided a safe context for me to explore - gently, over many weeks so that my brain could listen to my body and recalibrate - movement that I had learnt to avoid, and to learn that movement was not only safe but felt helpful and liberating.

Useful links and resources:
- These two sites are mentioned by Lorimer Moseley and have been created to provide help for people experiencing chronic pain:

- This is a link to a pamphlet on persistent pain, produced by the Tasmanian health system. It is very simply but thoroughly explained.

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