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Lets begin this section by answering two questions.
1. My _____________________ hurts.
2. _____________________ is the origin of my pain.
How did you answer these questions?
1. The first question can be answered by “back, knee, neck, or any part of the body that is involved with your pain. There is no right or wrong answer.
2. If you answered “the back” for the first question. I hope that you did not answer with only “the back” for the second question. Do you remember the chapter on stories and metaphors to help explain pain? Pain can be associated with the back. But it also can be related to sensitization of the nerves, sensitization of the brain, protective mechanisms, expectation of pain, stress, anxiety, or thinking that there is a problem with the body part.
By understanding that there are multiple components associated with the pain process. It gives you the possibility to improve. We cannot change arthritis, but we can change sensitivity of the nerves and brain, protective mechanisms, stress, anxiety and worrying about a body part. This can be done with manual therapy, movement exercises and understanding pain science. I am sorry if i sound like a broken record.
Even though pain can originate from the body and brain. Pain is always real. Lets not forget that. But when we stress or worry that a body part is injured, there is more pain. Stress or worry about a body part this can lead to over exaggerated thoughts about the body part, negative thinking, and emotional stress associated with the body part which will trigger increased protective mechanisms and increased pain.
In 2009 Phillip J Quartana, Claudia M Campbell, and Robert R Edwards published the following statements:
1. Pain-related stress or worry promotes negative cognitive and emotional schema brought to bear during actual or anticipated painful stimulation.
2. Pain related stress and worry can increase the threat value of a pain stimulus, increase the feeling helplessness in the context of pain, and promote the inability to inhibit pain-related thoughts in anticipation of, during or following a painful encounter.
If we feel hopeless, helpless, stressed, or worry about a painful process there is increased protective mechanisms to increase pain. Even anticipating pain can increase pain.
A question I hope you are thinking about is…. How do we stop stress and worry? As mentioned above, we must understand all of the reasons we can experience pain which can help decrease the negative thought process. Positive change can be made through self corrective exercises that you can read about and perform on your own!
So if you have have been told that you have a rotator cuff tear, arthritis, a tear in your cartilage, your joint is bone on bone, you have a disc bulge, or your alignment if off, well guess what??? There are many research studies that have found there is minimal relationship of pain with the aforementioned mentioned issues. This was discussed in the section regarding the relationship of arthritis, spinal discs, and degenerative joint disease with pain. That is another reason to decrease stress and worry about your body.
My training regarding stress and worrying about the body is based on movement exercises, manual therapy, breathing techniques and brain exercises. You should also discuss this topic with your physician because you may benefit from a consult with a professional counselor to help you understand how your body combats stress, anxiety, and worry that is involved in our daily lives. There is nothing wrong with that. Stress is required for body to function, but too much stress results in negative effects.
Darlow B, Dowell A, Baxter GD, Mathieson F, Perry M, Dean S. The enduring impact of what clinicians say to people with low back pain. Ann Fam Med. 2013 Nov-Dec;11(6):527-34. doi: 10.1370/afm.1518. PubMed PMID: 24218376; PubMed Central PMCID: PMC3823723. Free full text
Leung L. Pain catastrophizing: an updated review. Indian J Psychol Med. 2012 Jul;34(3):204-17. doi: 10.4103/0253-7176.106012. PubMed PMID: 23441031; PubMed Central PMCID: PMC3573569. Free full text
Quartana PJ, Campbell CM, Edwards RR. Pain catastrophizing: a critical review. Expert Rev Neurother. 2009 May;9(5):745-58. doi: 10.1586/ern.09.34. Review. PubMed PMID: 19402782; PubMed Central PMCID: PMC2696024. Free full text