Recently I have been discussing pain a lot with clients and whether pain equates to pathology. Pain is a complex issue that involves many body systems, but pain is only pain when the brain concludes it is. So does pain equate to pathology?
Pain is a warning mechanism, usually activated in response to noxious stimulus, such as bumping your elbow. It is only once the brain decides that the body is in danger, and that an action is required to protect it, that we experience pain. Pain is the body’s way of telling us to slow down or to rest.
People experience pain differently. What one person may perceive as 4/10 pain, another person may perceive as 10/10 pain. This difference in the perception of pain is modulated by particular beliefs, experiences, knowledge, social and educational backgrounds along with other cognitive factors.
When pain has become chronic, the threshold to cause pain is lower. Hence, pain is experienced even when the tissues are not in danger of further damage. This is commonly seen in people with recurrent low back pain (read Low Back Pain article), when a normal movement like twisting or bending can cause severe pain.
The definition of chronic pain is pain that has been present for more than 12 weeks. Chronic pain may arise from an initial injury, such as a back spasm, or there may be an ongoing cause, such as illness. However, there may also be no clear cause. Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain.
While pain may be a sign of danger to the body, with rest is often being the best treatment, chronic pain is treated differently to help rewire the brain and restore function. Evidence suggests that general exercise is one of the best treatments for chronic pain. Pilates is even more ideal because it teaches movement in functional patterns, but also provides those with chronic pain with positive movement experiences due to the supportive nature of the equipment.