Understanding pain, and the suffering that it causes, still eludes us despite decades of research in the field.
Chronic pain is recognized as the most frequent cause of disability in the United States and many other industrialized nations today. The diagnosis, physiology, symptoms, and treatment of acute vs. chronic pain are quite different and require separate consideration.
There are unique challenges for health care providers associated with each of these two categories of problems, and failure to distinguish between these types of pain has led to widespread, ongoing mismanagement of patients that can be prevented.
There are a wide array of definitions to be found but for this article, the following are most helpful:
Normal or acute pain alerts us to an injury or disease by sending a signal saying to the brain “you are hurt here, attend to it.” It usually dissipates after the tissue has healed. But sometimes an injury can damage both our bodily tissues and the nerves in our pain system (called “nociceptors”) and brain, such as in chronic pain. Even after the local injury has healed the brain still interprets the incoming information from this initially injured area as pain. In these cases, the pain can persist long after the rest of the body has healed.
This is where the term “neuroplasticity” comes into play. This once very controversial term is much more accepted in science today and relates to the ability of the brain to change itself for the better: for example, improving your memory by diligently engaging in “brain games”; or worse: in the case of chronic pain where the brain interprets pain for an area where there is no actual injury anymore.
With this point of view in mind, it becomes clear that we need to treat types of pain very differently from one another.
APPROACH TO ACUTE PAIN
As a German-trained Osteopath I look for how we can best assist the body’s own healing mechanism in the case of acute pain. With manual hands-on techniques we might realign joints, fascia, tendons or ligaments that were sprained or strained, we might encourage blood flow to an area to speed up healing, and work the tissue to discourage excessive scar tissue formation.
This approach can also be applied to pain and dysfunction of the organs, post-surgery, during pregnancy, and postpartum.
APPROACH TO CHRONIC PAIN
In the case of chronic pain, we might surprisingly stay away from any direct contact with the site of the initial injury. This approach is highly individual and will look different from patient to patient, but we often see that the brain perceives even more pain with the most gentle techniques, which defeats the purpose of any pain reduction attempt.
It might be beneficial to apply manual therapy techniques to other parts of the body to “even out the noise” of continuous information from the initial injury site. It might also be helpful to bring different “information” to the affected area.
As you might remember from earlier in the article, pain is interpreted by the brain from messages from nerve cells called nociceptors. If we encourage intake of other information, such as slow movement (perceived by Ruffini ending’s) we also have the opportunity to override the “noise” of pain perception.
As you can see, the management of chronic pain becomes a lot more complex very quickly and the need for an individual assessment to determine treatment is crucial.
At Elevate Wellness we offer a wide range of options. A conversation with our front desk staff, or a consultation with a therapist, may help to determine which treatment you might benefit most from Bodywork (Osteopathy, Structural Integration, Neuromuscular Therapy), Acupuncture/ herbs, dietary changes (Holistic Nutrition), or mental health coaching (Somatic Experiencing).
— Janine Blanchard, RCST, Osteopath (Germany)