“Fear of pain was more disabling than the pain itself”
Your body instinctively tries to avoid pain, and it is inherently built to sense it, interpret it, and guard against it. This function is an important protective mechanism that allows us to identify danger or injury and protect ourselves from further damage. When a painful stimuli is felt a signal is sent to the spine and then to the brain to interpret the information. Luckily, the body can react quickly to avoid further harm.
Beyond the physical sensation of pain, there is another factor that has a powerful impact on the body—how we think about or perceive pain can affect the body’s healing and recovery process. This is certainly the case with spinal-related pain. In fact, our cognitive processes can positively or negatively affect how we recover. It has been suggested that certain beliefs and attitudes about pain can increase your likelihood of chronicity and disability and delay recovery.
Here are some of the potential cognitive barriers to your recovery:
Beliefs and Attitudes
When you are in pain, it is natural to think about it and adjust your behaviour to adapt. For most people, the body quickly identifies a painful stimuli and reacts to avoid further harm—which is why you pull your hand back when you have touched something hot, or lift your foot off the ground when you have stubbed your toe. Your body also automatically starts the healing of tissue as soon as an injury has occurred.
Yet at times we can have certain beliefs about pain that end up hindering our recovery. For example, believing that pain is harmful or disabling may lead to avoiding activity and movement (thus trying to protect oneself), or unnecessarily guarding the area of injury. Also, “catastrophizing” or thinking the worst about your symptoms can exacerbate them, both psychologically and physiologically. Believing that you have no control over the pain and recovery process can become a significant barrier to getting better and resuming daily activities.
Expectations
We all hope for a quick recovery from back and neck pain, or any pain for that matter. Having unrealistic expectations about the time needed to recover can have a negative impact on one’s psychological well-being, which can have direct consequences on how your body recovers. In other words, by under-estimating the expected time of recovery, you are doing your body more harm than good. So, keep in mind that, depending on the nature of the injury, the time needed to regain function or alleviate symptoms may take longer than expected. Be patient as you heal and improve.
Emotions
We all typically experience an emotional reaction to pain. Common emotions include fear, anger, guilt, frustration, and even depression. For example, fear of pain with activity can delay recovery and return to work, because you are holding back in the physical aspects that would help you restore mobility and return you to activity. Similarly, some may feel stress or less of a sense of control.
Interestingly, even though the relationship is not yet well understood, depression (or a persistent, long-term low mood) is one of the strongest predictors of chronic pain.
There is no doubt that suffering an injury and pain can be an overwhelming experience, but employing different coping strategies can certainly help you in your recovery. There are a number of possible techniques and treatments available to assist in managing pain through addressing emotional and psychological factors. One important way to reduce the psychological impact of spinal pain is to have a good understanding of the problem – this is often termed Pain Neuroeducation. Our chiropractors are well trained to provide this type of education. In addition, treatment options may also include meditation, mastery of mind, biofeedback and cognitive behavioural therapy, to name just a few.
This article has been adapted from the Canadian Chiropractor’s Association.
Kyle Keenan
