Persistent Chronic Pain
One in 5 Australians over the age of 45 lives with chronic pain. This number increases up to 1 in 4 in people aged 85 years and over.
Chronic pain can be debilitating and stressful, and may impact your ability to work and complete those activities that are most meaningful to you. Knowing that the number of people living with chronic pain is increasing, we at MVP are motivated more than ever to shine a light on what is a very complex and hard to understand condition.
What is Chronic Pain?
Chronic pain is referred to as any pain that lasts beyond the normal expected healing times for the body – usually between 3 and 6 months. While intensity of pain may vary person to person, chronic pain is characterised by a constant or ongoing pain most days of the week.
The initial cause of pain may be due to an injury, surgery, musculoskeletal conditions or medical conditions. In some cases, people may experience pain that is not due to a physical cause, but rather stress, emotional distress or mental health conditions. This shows us that pain is not just a product of a physical mechanism but can be due to multiple factors. As physios, we are taught to think of pain as both an input to the body and an output. If the body can experience pain without an external impact or mechanism of injury, then this indicates that our body and nervous system is capable of not just receiving pain signals but generating them. This in itself is a whole can of worms, but in simplest terms what this means is two things:
That pain does not occur only because of a physical injury or damage
When you experience pain, it does not correlate with further damage to the area
When the body experiences pain due to an injury, it goes into a healing mode. Soft tissues (such as muscle) usually take between 4 to 6 weeks to heal, bones between 6 to 8 weeks and ligaments between 6 to 12 weeks. Unless you are continuously reinjuring the area, the body is able to heal itself between these time frames. However, we stated before that chronic pain exists when our body continues to experience pain even after this healing process has been completed.
When you have had long-term pain, several changes occur to your musculoskeletal system as a result…
If your pain has lasted longer than 4 weeks your body will have started to lay fat down in the muscle layers, regardless of your weight, this phenomenon occurs. This will continue as time passes.
Fat has now been found to not only be a storage of calories for future use, but also capable of releasing a host of chemical messengers. The fat stored within the muscle can increase the degree of inflammation, leading to chronic inflammation, altering the muscles capacity to get energy and triggering further pain cycles.
Fat in the inter-muscular area also decreases the muscles’ capacity to generate force and thus it affects muscles surrounding the spine to provide support and protect the joints from further injury or to move properly.
Can These Effects be Reversed?
YES!
Recent research has shown that it is possible to “reclaim” muscle tissue and decrease the amount of inter-muscular fat by resistance training. However, there is a catch – as the muscle is weaker, initially, resistance training may cause a little more “fatigue” pain of the muscle, and as you may have experienced pain for many years, your brain may interpret this as “pain to avoid”, rather than “pain that is going to lead to healing”.
Research has shown you achieve better results when exercises are supervised and progressed by an appropriate health professional such as an Exercise Physiologist of Physiotherapist.
With diet involving calorie restriction: A good diet and losing fat will help reduce the inter-muscular fat deposits, reducing the chronic inflammation, increasing the muscles capacity to contract and your mobility. It also decreases the load that your joints must carry, and so if they are causing pain due to some early joint arthritis, the joints will be relieved by less load.
How Long Will it Take?
If you have had spinal pain for a long time, then it is likely that a minimum time frame for improvements would be 3 months of dedicated exercise to reclaim muscle tissue. Every person’s journey to recovery is different, as your condition and needs are individual to your own situation. Your Physiotherapist or Exercise Physiologist will be able to inform you and keep you updated on your roadmap to recovery.
At My Vitality Physio, we aim to help you reduce the intensity and frequency of your pain, while improving your quality of life through hands-on treatment when required and with a very important focus on education and progressive safe exercise. This has been clinically proven to be the most effective way to manage and overcome persistent pain.
We are excited to go on this journey with you to better health and quality of life. Please feel free to chat with us about your ideal plan.
If you would like further information on how chronic pain works, Professor Lorimer Moseley is a pain specialist who has a fantastic project called “Tame The Beast”, which endeavours to help people better understand persistent chronic pain. You can view his work here.