Chronic Pain Cycle

Chiropractor Anna Papadopoulou Explains What Chronic Pain Is.

Have you ever considered the reasons that perpetuate chronic pain? Why has it been there for so long? ‘ I’m fine for a few months but it re-occurs with increased intensity, or the frequency is higher? I haven’t been doing anything different..?’

Chronic pain occurs when an acute injury fails to recover on time and successfully move to the healing process, because of mechanical, chemical or emotional re- aggravation.

Let’s have a look at this process using an example. A 34-year-old lady is in a hurry, misses a step and goes over on her ankle. The ankle swells and she is unable to walk on it. The doctor tells her keep active but to rest and ice the ankle to reduce the inflammation.

If the lady is careful enough and follows some supportive rehabilitation after the acute inflammation has subsided then she has a good recovery prognosis.

On the other hand if she doesn’t use the ankle at all or doesn’t weight bear at the correct time then the brain becomes increasingly more sensitive to the right ankle because there is not enough feedback from this region. Thus the brain in an attempt to increase the feedback will reduce the pain threshold, so now even gentle pressure or walking, that should not normally be painful is now painful (this is called allodynia)

Behavioural changes will also facilitate the” fear avoidance behaviour” meaning now because it’s sore it is less likely that you want to walk into town or take the dog for a long walk. Thus you start moving with less freedom. The muscles now are trying to adapt to the change of forces hence it lays down more collagen to strengthen the muscles and this is what leads to formation of more adhesions thus reducing the flexibility in the range of movement of the ankle.

If at this point the lady doesn’t act to change this pattern the sensitivity will keep increasing and the pain threshold will keep decreasing, perpetuating the cycle of chronic pain. A key factor for change is increasing function and movement within the joint. Facilitating the breakdown of adhesions increases sensory feedback to the brain and improves local circulation.
Chronic Pain Cycle

Chiropractic management increases feedback to the brain, improves function and in turn, the brain decreases its perception of pain. The ankle example can be extrapolated to neck pain and headaches, low back pain and repetitive strain injuries of extremities such as tennis elbow or plantar fasciitis (a disorder that results in pain in the heel and bottom of the foot).

For more information don’t hesitate to contact me to ask further personalised questions specific to your problem.

Next I’ll follow up with information about inflammation – how to prevent and manage it.

 

Anna Papadopoulou
Chiropractor