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Persistent Pain by Danny Miller

Persistent pain can be an awful experience – having pain in the body and not knowing what to do. Persistent pain is commonly found in the neck or the lower back. I have recently completed a pain course run by Peter O’Sullivan, which was really fascinating and highlighted that pain does not mean damage, rather it’s the body’s perception of a threat, a sign that the body needs protecting. This can show up as something as common as tight back or neck muscles, for example what does my neck or low back feel like at the end of the day?

If we feel threatened our body’s stress response kicks in, releasing adrenaline and giving us the ability to fight or run away. In the case of persistent pain our bodies will tense up, sensitising pain structures in the low back or neck. It’s like having a house alarm, which goes off when the wind blows on the front door. For example, giving myself a paper cut can really hurt, but in reality there is very little damage. Mental state can further increase the sensitivity of this alarm, so if we are feeling tired, stressed or a bit down this can magnify our body’s response to pain.

I have seen examples of this with various patients, long-term back pain that has not shifted from an injury that happened months, or even years ago. The injury was usually around a time of major or stressful life events that have subsequently magnified the injury. In some cases the situation has resulted in the patient having to take strong painkillers or undergo unnecessary scans, an overreaction to the real underlying issue.

Enjoyable activities and mindfulness have been shown to change our body’s perception of pain and break the cycle of persistent pain. Taking part in enjoyable activities gives us a chance for self-care, we can go for a nice long walk or play with our children. It doesn’t mean spending hours doing something that we think we should be doing, but that really isn’t appealing to us. Mindfulness gives us a chance to switch off from the pain, focus on deep breathing and in general show ourselves some compassion.

If anything in this blog resonates with you, or you have questions, please do give me a call.