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Good vs Bad Pain

Audio Version!!!

Thank you so much for joining The Body Mechanic Blog. I hope you enjoy it, and I hope enjoy this journey into health, fitness and longevity! As always, please share this, as well as any other, post with people you care about that you believe could benefit from the information. Now, on to the topic of the day… Good vs Bad Pain

“Pain is not the same as suffering. Left to itself, the body discharges pain spontaneously, letting go of it the moment that the underlying cause is healed. Suffering is pain that we hold on to. It comes from the mind’s mysterious instinct to believe that pain is good, or that it cannot be escaped, or that the person deserves it.”

–Deepak Chopra

There is a lot of confusion about the nature and value (if any) of pain. Chances are very good that you see pain as something to be avoided at all costs.  Moreover, it seems that there is an almost ubiquitous misconception of where and how pain originates.  Therefore, my reason for this eLetter is to help you to understand what pain really is and where it comes from, so that you can develop a healthy relationship with pain. And I hope to convince you that once you shift your paradigm to a healthy view of pain, you will not only no longer fear pain, but you will understand that pain will indeed make you stronger than you otherwise could have been without it!  Sound crazy?  Well, this concept is often the first principle that I teach my clients who come to me in pain.  And, of course, I am almost universally met with incredulity.  So, I am going to ask you to do the same thing that I ask each of my new clients – Trust me now, and you will believe me later!

Here is the crux of my thesis: Pain is a perception, produced in your brain. Moreover, your brain does not recognize “pain signals” coming from your body. Indeed, you can feel pain without having any bodily damage whatsoever; and by the same token, you can feel no pain when there is severe damage. Let’s investigate further.

According to Dr. Eddie O’Connor, clinical sports psychologist, we have no way of measuring pain objectively.  We can’t take a picture of it or have it show up in a blood test. We can point to a possible cause of pain, but pain itself is a subjective experience.  As Dr. O’Connor explains, “Pain is a bio-psycho-social experience. A physiological signal goes from the shin, for example, up to the brain where it mixes with your thoughts, emotions and interpretations of the social context.  And then you have a pain perception. The pain is not in the shin.  It is processed in the brain, telling you the problem is in the shin.”

So what do I mean when I say pain is a perception?  To answer, think of pain as a perception in the same way that vision is a perception.  You probably believe that vision is a straight forward process in which you “see” what enters your eyes.  But that simply isn’t true.  Once the light enters your eyes and makes its way to your visual cortex, your brain then interprets what you “see” and then, based upon many variables, perceives what it determines is an accurate picture.  What you “see” is your brain’s interpretation of reality.  It is important to understand this concept.  To see what I mean, please take a look at the following image.

I am sure you believe the top panel as darker than the bottom one. But if you hide the information in the middle, you can then see that the two panels are exactly the same shade of gray.  The reason optical illusions work is because you see only what your brain determines you should see.

Now, let’s look at the perception of pain.  Imagine two types of sensory neurons (nerves) in your body.  Along with your sensory (afferent) nerves, you have special sensory neurons in your body called, nociceptors.  In my experience, many very knowledgeable professionals mistakenly call nociceptors “pain receptors”.  But this is inaccurate!  Nociceptors do indeed send signals to the brain, but these signals are sent only under specific conditions, and by specific types of nociceptors.  A nociceptor only sends a signal when a specific threshold has been exceeded.  You have nociceptors that are activated when a certain level of heat or cold is exceeded; some nociceptors are activated when a certain level of pressure is exceeded; and some are activated when chemicals are in the tissues that should not be there (for example, some chemicals should only be inside your cell’s membrane, and when a cell is broken those chemicals spill out, activating the local nociceptors.  Note that a cell can be damaged by a cut, scrape, virus, or bacteria for example).  And when any of these nociceptors reach their threshold and are activated, they then send a signal to your brain.

To put this into perspective, let’s imagine you step onto a scale and it reads 130lbs (Most of my clients are female, so this is the weight I tend to use in my examples). That readout is simply an image that enters your eyes (as light input) and goes to your brain.  That image is not an anxiety signal.  However, when your brain interprets 130lbs, it may result in you feeling a lot of anxiety! This may be because you have a preset threshold of 125lbs, and any readout that shows more than 125lbs produces anxiety.  Now imagine if the scale were a special scale that is set to only show your weight if and only if it exceeds 125lbs (in other words, 125lbs is your brain’s threshold). What would happen if you step on the scale and your actual weight were 120lbs?  Nothing.  However, if you step on that scale and your actual weight is 126lbs, then that number is shown and you see it (i.e. perceive it).  Your brain may then get only slightly anxious.  But anxiety would be commensurately higher if the scale were to show 130lbs.  This is essentially how pain and pain levels work.  Just understand that the actual pain perception is produced in your brain.

OK, so nociceptors don’t send pain signals to the brain.  Instead, nociceptors send “we have exceeded our defined threshold of [pressure, chemical, heat, cold]” signals to your brain, specifically to your spinal cord which relays the signals up to the Thalamus in the diencephalon of your brain.  Your brain in turn determines how much pain you “feel”. And you feel pain if it is biologically advantageous to feel pain.  Clearly, if you step on a nail you need to feel pain so that you can immediately address the situation.  And that pain would likely be intense.  However, what if you are being chased by a hungry lion as you step on that same nail? The pain would likely be far less intense, right?  In each scenario, there is the same amount of damage to your foot, and your nociceptors would send the same signals to your brain.  But the pain level would be different because it would not be biologically advantageous for you to stop and address the nail in your foot!  Indeed, you would probably not feel the need to address that foot until you had scaled that impossible-to-climb tree and were well out of harm’s way.  At that point you may also notice the chunk of flesh missing from your left side. Now you can feel the pain!

So how is this knowledge helpful?  Now that you have a new paradigm of pain, how can you use it to be healthier and more resilient?  First, you must understand that your body has the capacity to recover from nearly any injury (unless you are immunocompromised, and even then we should talk).  And I include in this list the common problems such as tennis elbow, achilles tendinitis, runner’s knee, plantar fasciitis, torn rotator cuff, bursitis, back pain, neck pain, etc.  And not only can your body heal these conditions, you can and should be stronger once you are healed!  In my experience, the primary reason a person doesn’t heal is because the body tightens up because of pain.  And when the body tightens up, it becomes ischemic, reducing blood flow to and waste removal from the injured area.  Then you have a chronic problem.

Secondly, we have already established that pain is produced in the brain, and is mitigated by a variety of factors.  One huge factor is emotion, and in particular, fear.  Fear is the emotion that causes or amplifies the sensation of pain.  But what if you could train yourself to not fear injury? What if I could convince you that the nagging pain you feel in your back or elbow or shoulder or hamstrings is for sure created in your brain and amplified by fear?  Consider this: If you have pain in your right shoulder, the only pertinent question you should ask yourself is “am I making the condition worse by flexing my muscles and moving my shoulder?”  If the answer is “no” (and in my experience it almost always is!), then the thing to do is to flex your muscles and move your shoulder.  However, “The Man” has programmed you to ask, “Does it hurt when I move my shoulder?”  And since the answer is definitely “yes”, then you simply don’t want to move your shoulder.  And here is the kicker — if you move your shoulder, then you likely exacerbate the tension and pain!  I know, it seems like a catch-22, doesn’t it?  But it isn’t.  Not for you, as long as you understand my words.  This is why it is of utmost importance that you see movement as mind-brain-body practice.  Every time you move and feel pain, it is an opportunity to build the skills necessary to mitigate that pain.  Once you feel the increased tension and pain, recognize it as fear and not damage, and then slowly and deliberately repeat the movement.   As you can see, this kind of special skill can only be acquired via actual experience.  However, if you allow fear to rule you, you will move less.   Most people will avoid the movement because of the increased pain.  And as they move less and less in attempts to avoid pain, they run the risk of developing frozen shoulder syndrome.  So, this is why the key is to learn how to move with pain.

Thirdly, “The Man” tells you to avoid touching an injury, and massaging an injury is definitely out of the question. Here again, the question should have nothing to do with pain.  The only consideration is whether massaging your injury will exacerbate the injury or help it.  If your goal is to increase blood flow and help to remove waste, then isn’t it clear you should massage your injury, regardless of pain?  Indeed, if you move regularly and judiciously through the pain (instead of cowering or avoiding), and you regularly massage your damaged body part, you will become more courageous and confident as a result.  And as you become more courageous and confident, pain loses its grip on you, and you begin to relax even as you flex your muscles and move your joints, all the while feeling – but not fearing – pain.  A relaxed body is not ischemic!  Blood flows; waste is removed; your immune system therefore creates new tissue that is stronger than the previously damaged tissue.  You become, in effect, resilient — Just as I promised you!  And the key lies in your relationship to pain.  Does this make sense?  I have been injured many times and have had several surgeries to repair orthopedic damage.  Because of my decades of martial arts training, I have learned to not fear injury. Because of my training in massage and bodywork, I have learned the importance of waste removal and increased blood flow.  Because of my understanding of human anatomy and physiology, I expect my body to repair all damage.  And because of my understanding of the mind-brain-body connection, I know that belief is very powerful, and this translates into positive results.  I know this empirically.  And once you are empowered with this information, you too will come to know this.

Remember my vision for us — We will age together! But we will be different from previous generations. I want us to be functional centinarians, free from the chronic diseases and pains so common today. Know this:    Aging is mandatory. Maintaining functional fitness and vibrant health — well, that’s optional!

Have a super great day, and an even better tomorrow!  See you soon!

To Your Health!

Jeff Wooten, “The Body Mechanic”

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