All pain is real. Whether there is a pathological reason or not, the sensation of pain is felt in the same way and is 100% real to the person experiencing it. Pain cannot be simply switched off. Furthermore, persistent pain may cause changes in the brain that lead to fatigue, anger, anxiety and depression which in turn may cause loss of quality of life, of purpose and of any sense of control over our bodies and our lives. So what actually is pain?
Pain is an important survival response as it prompts us to get away from potentially dangerous stimuli. Pain is therefore a perception that is created by the brain to protect the body. Unfortunately, the brain does not always create a sensation that is proportionate to the stimulus. Take Lorimer Mosely’s story; Lorimer went hiking in Australia and felt a nick on his ankle. He brushed it off as a scratch from a twig and carried on hiking. A couple of hours later he was in hospital and became one of the few survivors of an Eastern Brown Snake bite. Five years later he was out hiking again, and again, felt a nick on his ankle. This time he experienced immense pain and was rushed to hospital. Turns out it was just a twig this time, but the pain lasted for another 2 weeks!
So what happened? Lorimer’s brain created a neural pattern that associated a nick to the ankle with the danger of a snake bite. This learned pattern was easily triggered 5 years later. If pain gets repeated or is traumatic, the brain forms neural pathways that are dedicated to it. In other words, the brain learns pain. Once these pathways are formed they may trigger themselves without any damage.
In a ground breaking study(1) in 2002, 180 patients with knee osteoarthritis received actual arthroscopic surgery or fake surgery. Interestingly, all patients improved equally regardless of the group. After 24 months there was still no difference in improvement between the two groups. Fascinating was that, even when told they were in the fake surgery group, the patients’ condition still kept improving.
In summary, if the brain can learn pain, it can also unlearn it via the process of neuroplasticity in which the brain connections re-wire. This process is far from easy and takes a lot of time and effort, much like learning a new skill. The end result however could mean a life without chronic pain. Osteopathy is one approach that can determine the mental and physical factors that keep activating the same neural pain loop and help to address them.
Martin Ludwig, Osteopathic Natural Health.