• Christina Hellmann

Understanding and managing pain

I attended a very interesting webinar yesterday hosted by Arthritis Action on understanding and managing pain.

As you can imagine, understanding how and why pain occurs is ridiculously complex! We are constantly researching it in an effort to further understand it and help those suffering with it. Mental, physical or phantom – pain affects people so differently. It’s estimated that one in four people in the Western world are in some kind of pain.

I’ve always been so fascinated by it and in my last year of study, I wrote my dissertation on something called ‘Fear Avoidance Behaviour’ and how it affects people with lower back pain. Fear avoidance behaviour is where someone who is in pain becomes fearful of moving in case it causes pain or makes existing pain worse.

I talk about fear avoidance behaviour in my practice a lot as I see signs of it in some of my patients. Unfortunately, if fear avoidance behaviour develops, it’s very common to fall into the trap of the fear avoidance behaviour cycle shown to the right. Lack of movement causes the muscles in the body to weaken and over time, this can cause more pain as the body loses its strength and stability.

As an osteopath, I see people in pain on a regular basis. It’s not only my job to help the body manage the pain but to also educate my patients so that they understand why the pain has occurred in the first place. That’s why I think knowing and understanding what the fear avoidance cycle is so important.

Why do we have pain?

Pain is there to keep us safe. Pain lets us know that something is wrong with the body. In cases of acute pain such as spraining your ankle, tearing a muscle or even touching a hot kettle, pain is felt instantly and that tells us that something bad has happened. The body deals with the injury and the pain eventually settles down.

In some cases however, the injury settles down but the pain doesn’t. This is known as sensitisation and it’s where the body becomes sensitive to things that wouldn’t ordinarily cause pain. The nerves are incorrectly signalling that there’s something wrong. People who develop this kind of pain can go on to develop chronic pain and are at a higher risk of developing fear avoidance behaviour. High stress or anxiety levels can also make the pain feel worse and research suggests that people who show signs of fear avoidance behaviour are more likely to be depressed or anxious. The key to overcome this is to break the fear avoidance cycle.

How to break the cycle…

MOVEMENT, MOVEMENT, MOVEMENT – I cannot stress how important it is to keep yourself moving. In the past it was thought that if something hurts, we should stop what we are doing and rest until we feel better. Research has shown time and time again that movement is one of the best things you can do if in pain. Mind-body activities such as yoga and pilates are particularly encouraged as they promote moving with peaceful intentions, exploring the mind-body connection in a way that feels safe to move. If yoga or pilates is not your thing, not to worry, opt for something else. It doesn’t even have to involve going to the gym. You can simply go out for a walk, do some baking, some gardening – anything that you enjoy. I said before in my last blog, when it comes to activity, there is absolutely no point doing something that you dislike. Activity shouldn’t feel like a chore. If you’re new to becoming more active, pace yourself so that you don’t deplete your energy too quickly and then you can work up to doing your activity for longer.

Other ways to manage pain include:

  • Eating a well-balanced and varied diet

  • Drinking enough fluid

  • Sleeping well

  • Keeping stress levels down – easier said than done in today’s world unfortunately but simple things such as taking a minimum of five minutes a day just to relax and focus on yourself can help.

If you need a hand…

If you are worried that you may be stuck in the fear avoidance cycle or are concerned about your pain, please feel free to contact me. One of the main reasons I became an osteopath is because I am passionate about helping people, especially those in pain. We can work together to come up with a plan designed specifically for you to start getting you on the right track and living a happy, healthy, pain free life!

#Pain #ChronicPain #Exercise