Managing pain through education is not a new concept, but David Butler and G. Lorimer Mosely, authors of Explain Pain, describe pain in words that we can understand. This gives people the knowledge required to manage and control their pain.
Many people who suffer from pain have no apparent sickness. Others have pain long after an injury has healed. Some examples are fibromyalgia, myofasical syndrome, chronic fatigue syndrome, nerve pain, non-specific back pain, chronic neck pain, and chronic muscle pain.
Understanding Chronic Pain in Simple Terms
Pain is a signal from the brain designed to protect the body from danger. Pain is not caused by “nerves,” but entire body systems. The nervous system acts in unison with the immune, endocrine, and motor systems to alert the brain to danger. Bulter and Mosely liken this to a finely tuned “orchestra.”
However, the brain makes the decision to trigger pain. Vast amounts of information including emotions, environment, memories, beliefs, and fears are considered before the pain response is triggered.
Social and Emotional Factors Influence Pain
The role of fear, emotions, and memories are often considered minor in comparison with physical injury. However, both physical and social pain share some of the same systems that signal pain (DeWall, 2010).
- For example, we may feel pain, become fearful, and the pain gets worse. As soon as we enter the hospital, the pain disappears. In the presence of expert caretakers the social environment becomes safe, fear dissipates, and so does the pain.
The Brain Uses Multiple Information Sources to Protect the Body
The brain listens to the orchestra of information from body systems, but also uses its huge store of memory and knowledge in deciding to issue a pain signal. For example:
- An individual suffered agonizing pain from a kidney stone. For ten years afterwards, he or she feels back pain every time someone mentions a kidney stone.
- Someone fleeing from danger sprains an ankle, but feels no pain until he or she is safe.
The brain decides whether or not to trigger the pain signal depending on its assessment of the danger of the situation. In the case of the kidney stone, there was pain without illness; in the second example there was no pain when an injury was incurred.
Understanding the “Virtual Body” in the Brain
Butler and Mosely use the word “virtual body” to describe how the pain center of the brain perceives the body. Some areas of the body are more important than others – these areas are huge.
- A paper cut in the finger hurts much worse than a cut in the thigh; the hand is used constantly – it is important.
- Even a feather touch causes extreme pain in the eye, because vision is important to survival.
The Virtual Body Can Be the Cause of Chronic Pain
Acute, life-threatening illness receives immediate attention and a pain response from the brain. However, chronic or recurring pain can be caused by a distorted image of the "virtual body" in the brain well after the tissue has healed.
When we are injured, all of the pain systems pay close attention to the injured area. In terms of the "virtual body," that area becomes very large and hyper-sensitive to pain.
Sometimes, the injured area continues to be the focus of the brain, and hurts after the actual tissues are healed. The virtual size of the area remains too large and an overly protective “orchestra” of signals may even cause other areas of the body to hurt.
The “Orchestra” of Pain Systems Goes Off Key
In simple terms, the “orchestra is out of tune,” so you are in pain even after your tissues have recovered – you may experience chronic neck, back, or shoulder pain.
Nerve pain, caused by an injured nerve, can short-circuit the systems involved in the pain signal. You may experience chronic pain, itching, numbness, tingling, and various other symptoms.
Chronic Pain Management is Brain Management
If you understand that the “virtual body” in the brain is greatly exaggerating your area of injury, you can slowly retrain your brain. Two factors are key in recovery:
- Knowing your tissues are actually healed.
- Knowing that movement hurts, but will not harm your body.
Convincing your mind that your body is healed is not easy, but Butler and Mosely believe that it can be done if you understand pain and have social and clinical support.
First Steps Toward Freeing the Body from Chronic Pain
Some examples of guidance provided by Butler and Mosely are as follows:
- Imagine that you are moving in the way that causes you pain; this provides the brain with a memory of the movement that is not accompanied by pain.
- Moving the injured area in ways that do not cause pain helps divert the interest of pain centers in the affected parted of the body.
- Practice deep meditation or do something that you love to do to decrease the brain’s attention. Have you ever been so engrossed in something that you forgot you were in pain?
- The exaggerated pain response can be slowly decreased by gradual use of the body just to the point of pain and extending it a bit each time.
- Moving slightly with gravitational support, such as in water or sitting down can help you begin.
According to Butler and Mosely, the very worst thing to do is to lie down and stop moving, which begins a spiral of increased pain and sensitivity.
Living with Chronic Pain Requires Social and Emotional Support
In the treatment of fibromyalgia, thinking positively is critical to avoiding the fear and depression that contribute to pain (Starlanyl 2007). Likewise, Butler and Mosely insist on surrounding yourself with supportive people and clinicians who are specialists in chronic pain.
A Thorough Understanding of Pain is Essential to Curing Chronic Pain
The methods described to reduce chronic pain are not all new, but Butler and Mosely are the first to explain pain in terms that you can understand. You can use this knowledge to conquer your pain.
READ MORE: Bulter, David S. and Mosely G. Lorimer, Explain Pain, South Australia, Noigroup Publications © 2003.
Other References:
C. Nathan DeWall, et al. “Acetaminophen Reduces Social Pain, Behavioral and Neural Evidence,” Psychological Science, 2010; 21: 931-937 DOI: 10.1177/0956797610374741
Devon Starlanyl and Mary Ellen Copeland, Fibromyalgia and Chronic Myofasical Pain, Oakland, New Harbinger Publications, Inc., 2001.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
