Pain causes physical and chemical changes to the mind and body. The most recent blog covered the theories of pain and opened the doorway to some of the concepts that I want to cover here. We’re all different in the ways that we perceive the world, and pain is no exception. On average males and adults have a higher threshold for pain. But simply being in pain can increase the sensitivity of the nociceptors (pain nerves) in the area. These nociceptors come in a few different flavors. Low threshold – these are the warning signals of pain, the stuff that lets you know if this keeps happening you might get hurt. Then the High Threshold nociceptors are sensitive to painful movements and strong pressures. These nerves are that ouch that say don’t do that. Lastly there are Mechano-Insensitive Nociceptors, these don’t tell your conscious about pain, they pick up on inflammation and help facilitate the inflammatory cycle.
When pain persists, even for those with a high pain tolerance you can end up with central sensitization. This is when your central nervous system (CNS) has been stimulated by pain enough that it is no longer able to appropriately rate and interpret the pain signals that it is receiving. Most commonly this takes the form of hyperalgesia, where the amount of pain from a stimulus registers significantly higher than it should. Think a bump into a counter feels like you got hit by a bat. The other is allodynia, where things that should not be painful register as pain. Think putting on tight pants brings you to tears.
These types of changes could theoretically happen after just one injury. But more likely they are the result of repeated injuries whether on the macro or micro level. This is often the result of cumulative trauma disorders, which are exactly what they sound like. The same area is harmed repeatedly, even if it’s done in different ways, the damage builds up. This happens on the macroscopic level and the microscopic level.
Nerves are covered with sheets of myelin, which helps improve how well they conduct signals. With persistent injury the myelin thins and its ability to conduct signals decrease, while its ability to be affected by aberrant or painful signals increases. Beyond that the endo, peri, and epineurium (layers of nerve groupings) all increase their vascularity. This results in an increase in the nociceptors and corresponding increase in pain frequency and intensity. The increased noise from the pain takes bandwidth from the non-pain sensing nerves and reduces proprioception (the body’s ability to sense where it is in space.
These disruptions can be non-traumatic as well. Sustained pressure can cause pain, injury, and inflammation. 30mmhg can block off veins, 50mmhg can block off arteries, and 80+mmhg cand cause localized ischemia (no O2 to the area). This is just a way of illustrating that your own muscle spasms or compensatory postures are more than enough to cause real damage and change the underlying structures significantly. Whether it is compression or tension, sustained force on the nerves will become a problem sooner or later. This can result in the nerve getting thicker to protect itself, which slows conduction, or scaring to happen at the nerve which would impair its function.
There’s significantly more to be said about pain and its effects on the body. Our next blog will address our approach to addressing pain. Hopefully this serves as the catalyst to make improvements wherever possible to free yourself from pain. If you’re not able to make the impact you want on yourself know that help is out there. At Invoke Therapy and Wellness we assess your pain and overall situation from all angles to make the most substantive changes for good possible.
