Pain is termed chronic when it persists for more than three months. There are many variables that result in chronic pain. Pain does not simply have a direct relationship to tissue damage. It can be influenced by many factors including past experiences, beliefs, environmental and psychological factors. Pain can have adverse effects on people’s ability to sleep, be fully involved in normal work, social and sporting activities as well as causing fatigue and depression. So, what keeps the pain going? It is our brain that decides if we feel pain or not.
Receptors in our body respond to stimuli perceived as being potentially dangerous. Typical examples of this basic phenomenon are the sense of pressure when you shut your finger in the cupboard, the sense of heat when you put your hand on a boiling kettle. The receptors send messages to our brain. Before they reach the brain those messages are not pain, just a message that your finger is squashed or your hand is too hot. On receipt of the message or impulse our brain decides if it’s the right time to translate the “danger” message into pain or not. Usually, it would be appropriate for your brain to perceive the danger messages from the hot kettle as pain, so you put it down and don’t get burnt. However, in a highly stressful circumstance such as if you’ve just been attacked and punched, it’s more important to escape, so despite danger messages from your receptors, it doesn’t hurt, and you keep running.
Chronic pain is not uncommon in Australians including those of working age. Many of these pain conditions are related to joint and muscle pains. So what is the role of the physiotherapist? Firstly it’s to explore the danger and safety factors for your brain. In their assessment, they will ask about why you think you have pain, your medical history, and observe how you move. Then they set about determining the most important factors to change. They address these issues in step by step approach so as to offer the brain "safety". Your physiotherapist can do this by helping you understand how your pain gets activated. Are there ways of moving that are a problem and how to change that. You may be encouraged to explore how certain thoughts and feelings effect your pain and strategies to manage that better. They may give you relevant broader lifestyle tips, and liaise with other healthcare professionals where other illnesses have an impact on your pain.
Joan understands musculoskeletal pain is a real and complex issue that affects people’s quality of life. She will take time to listen to you so as to understand you as well as examine what factors are causing your pain.