Pain is defined as an unpleasant conscious experience, and physical pain is controlled by the central nervous system in the body. The central nervous system is a network of nerves that connect the brain to the rest of the body to allow the input of information. When you feel pain, it means that your brain thinks the body is under threat, and that something has to be done about it.
When a body part is damaged, nerve endings are triggered and send warning signals to the brain. This triggers protective behavior, to minimize further damage and allow time for healing. This leads to immobilization of the area, results in protective muscle spasm and causes us to avoid movement. Once the body part has healed, the nerves endings in the area should calm down, stop sending warning signals to the brain, and the pain should end, allowing us to get back to normal movement and function.
Pain doesn’t always equal damage. Sometimes, the central nervous system becomes sensitized (especially if the pain has existed for a while) and the brain thinks part of the body still requires protection, even after the area has healed and there is no longer any physical injury or tissue damage. This is the case in chronic pain, where pain continues for long periods of time after the original source of the pain has healed. In such cases, there is a problem with the pain processing system, not the body. When an area becomes sensitized we can expect hypersensitivity, where even minor, non-painful stimulus can trigger a rapid pain response.
It has also been shown that emotional states such as anger, depression, stress and anxiety can reduce tolerance to pain. Although it is hard to believe, research provides strong evidence that a significant portion of chronic back pain is caused more by emotional and social factors than actual tissue damage.
Chronic pain causes the body to adapt the way it moves and can even result in certain movements being avoided altogether, due to fear of an injury flaring up and causing damage. This is known as fear-avoidance and is a major contributor to the continuation of chronic pain. A lack of movement feeds the pain cycle and actually makes the pain worse and prolongs recovery.
Moreover, when people are told that their posture may be causing pain or their movement patterns are dysfunctional, they will sometime obsess about trying to adopt a perfect posture and create perfect movement, rather than focusing on creating natural movement. There is no perfect movement or perfect posture. Everybody is unique and is very good at adapting to a range of activities and environmental demands.
What you believe about pain can have a very big impact on your recovery. If you have helpful beliefs (for example: some pain is part of recovery and does not mean more damage, therefore, it is safe to move), then you are less likely to experience ongoing pain. If you have unhelpful beliefs (for example: hurt equals harm, so I am doing more damage by moving), then your recovery is likely to be slower and you are more susceptible to developing persistent or chronic pain. An accurate assessment by a physiotherapist, learning healthy movement through Pilates, and positive beliefs about your body’s ability to heal and recover can help you overcome pain faster and avoid (or reverse) the potential downward spiral of chronic pain.
Why are movement and exercise so important for pain management?
- Research has shown that movement and exercise are very helpful to reduce pain and improve function for people with low back pain, and is a key component in recovery.
- One of the primary ways that movement can reduce pain is through the phenomenon of sensory gating or pain gating. This means that while your nervous system is processing signals resulting from active movement or touch, it has less ability to perceive and process the pain signals. A good example of sensory/pain gating is when you stub your toe and instinctively rub or hold the area. In the same way, coordinated controlled and mindful movement will reduce the perception of a painful stimulus and relieve pain.
- Improving your movement skills is a way to reduce perceived threats that are related to movement. Efficient movement helps to calm a threatened, over-sensitized nervous system and reduces pain.
- Movement also helps to improve blood circulation and lymphatic flow flushes away toxins and lubricates and nourishes the joints, keeping them healthy.
- Some other benefits of exercise are:
- regulating sleep patterns;
- reducing stress and anxiety;
- elevating your mood;
- improving immune function (your body’s ability to fight infection or illness);
- boosting general health;
- helping with weight-control; and
- maintaining brain health.
As Joseph Pilates said: “Change happens through movement, and movement heals.”