Like anxiety, pain is a hard wired alarm that we all have the capacity to experience in the right circumstances. Pain is the outcome of your brain sensing that something is wrong or is doing damage to your body. This does not mean that you are making it up, as is often mistakenly believed. What this means is that the pain centre located in your brain has received a signal from the nerves around the damaged site. Pain is important for our survival. Without pain, we could do serious harm to ourselves. For example, without feeling the sharp pain that follows a broken limb, we would carry on using our broken limb and cause even more damage. Normally, the nerves will stop signalling when healing has occurred. However, sometimes there are changes to the nerves or nervous system, such as may occur from surgery, which keeps the nerves firing and singling pain. When the nerves keep firing signalling pain, there are changes to how the central nervous system works that makes people more sensitive to the things that should hurt and get more pain with less provocation, even though they actually have no way of telling if their pain is actually worse than it should be. Pain is said to be chronic if it persists beyond the normal healing time for 3 to 6 months or more.
What are the symptoms
Experiencing chronic pain?
The feeling of pain comes from a series of messages that go through your nervous system. When you hurt yourself, the injury turns on pain sensors in that area. They send a message in the form of an electrical signal, which travels from nerve to nerve until it reaches your brain. Your brain processes the signal and sends out the message that you are hurt. Usually the signal stops when the cause of the pain is resolved - the 'fire is out' when your body repairs the wound on your finger or your torn muscle; the alarm shuts off. But with chronic pain, the nerve signals keep firing even after you've healed; the fire alarm won't shut off! It is as though an electrician has rewired all of the circuits in your house without your knowledge until you turn on the lights and instead the computer and tv turns on instead. This rewiring totally distorts how you experience your pain and may leave it quite far from the original source of the pain. Chronic pain can range from mild to severe and it can negatively affect your day-to-day life and cause depression and anxiety. It can continue day after day or come and go. Chronic pain can feel like the symptoms mentioned below.
A dull ache
Feeling very tired or wiped out
Not feeling hungry
A lack of energy
facts about chronic pain
Did you know...
An estimated 20% of Australian adults suffer chronic pain, that's 1 in 5 of us and includes children and adolescents! The numbers jump to 1 in 3 for Australian adults over 65.
Injury is the most common cause of chronic pain (38%), though a further third of all people who experience chronic pain are unable to identify the original cause. Other identified causes include arthritis, musculoskeletal conditions, headache, cancer-related pain, post surgical persistent pain and non-specific lower back pain.
In 2015, chronic pain cost our economy more than $34 billion and was Australia's third most costly health condition after cardiovascular disorders and musculoskeletal issues. This has to led to the claim that it's prevalence is reaching epidemic proportions.
It is possible to effectively manage 70-80% of chronic pain. Sadly, despite this, only 10% of those affected are getting access to adequate treatment.
what are the warning signs
Look out for the signs
Who will develop chronic pain? There is no easy answer to this question. It is now understood that psychosocial skills and mood factors and past trauma are stronger predictors of chronic pain post-operatively than surgical factors, genetic predisposition, acuity and duration of postoperative pain, anaesthetic factors, gender (female), type of disease including recurrent of malignancy, and adjuvant therapy: radiation, chemotherapy.
Furthermore, chronic pain seems prevalent in many people with anxiety and depression, personality disorders, post-traumatic stress disorder and drug/alcohol and substance abuse and people who do not understand the nature of pain, who do not believe that they can cope well with pain, and have minimal social support post-operatively.
what treatment is available
There are options
There are a number of psychotherapies that have been found to be effective for psychological pain management so that chronic pain does not remain your focus. These psychotherapies help you to reduce pain focus, think differently about pain and use imagery, relaxation techniques, meditation, and mindfulness to help you feel more in control of your life, connected to others and able to pursue pleasurable activities. Your psychologist will tailor treatment to your individual needs using interventions from evidence-based treatments like:
Cognitive Behaviour Therapy (CBT), Mindfulness Based Cognitive Behaviour Therapy (MCBT)
Acceptance and Commitment Therapy (ACT)
Eye Movement Desensitisation Reprocessing (EMDR)
Trauma Informed Yoga
Mindfulness Based Stress Reduction (MBSR)
Solutions Focused Therapy