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To be in pain or not to be in pain…

To be in pain or not to be in pain…

We have felt it, we have complained about it, and chances are it has caused us to miss out on a social event or two. No, not the cold weather or snow we are always so surprised to see in the middle of winter in Canada (what?! It’s snowing today? But, it snowed yesterday…). I am talking about pain: the 7.2 billion dollar industry, and one of Canada’s biggest epidemics. Pain has been a “hot topic” in health care recently. Perhaps because recent research has basically taken what we thought we knew of pain and turned it around like new drivers in Cornwall’s traffic circle.

If you had asked a health professional 10 years ago, they would say pain is a “warning sign”. Your body senses that something is wrong and warns the brain so that you can make an appropriate change. Warning, your hand is burning, you better pull it away from the stove! This theory makes sense. But now think of it this way: if pain is just an alarm system that carries a warning the brain, then taking away your alarm should take away the pain. But, full arm amputees get excruciating “phantom pain” in an arm that is not even there. There is no stimulus, there is no alarm, there are no nerve pathways. Yet, there is pain…how? Questions such as these have sparked the research that have merged to form a theory that pain is actually an “output” from the brain. This means it is not a message that the brain receives from an outside threat, but a concept formed within the brain itself, that is carried out to the body. Think of it this way: you are flipping through your favourite magazine and suddenly you get a paper cut…THE AGONY! After whining for a few minutes and somehow coming to the conclusion that sucking on your finger will help, you carry on with your life. At the end of the day when you are brushing your teeth, you look down and notice your paper cut. Oh yeah…you had forgotten about it. You had forgotten it happened because the pain stopped. Yet, the cut is still there, and it hasn’t healed. There is tissue damage, but no pain. What happened? Your body decided that it no longer needed to feel that pain, after all, it was just a paper cut. This is how pain is supposed to work. There is a set of subconscious processes that you go through that determine the need to feel pain, and down regulate the pain if it is considered not a threat. Where did that bruise come from? This is another example of tissue damage without pain when your brain did not feel the need to sound the alarm. Looking at pain in this way completely changes how we treat it. It means that pain does not always equal damage, and that blocking pain receptors or fixing damaged tissue does not always fix the pain.

It means that patients with chronic pain may have other factors that are actually stopping the down regulation of pain.

In fact, studies have found that there are psychological and social factors that can do just that; stop the parasympathetic nervous system from “shutting off” your pain. Stress, for example, can keep us in an “always alert state”, stopping us from “shutting off” the pain like in the example with the paper cut. Therefore, the only true and viable solution to curing your pain? Quitting your job and moving to the Bahamas where you can drink Mai-Tai’s served to you from your personal butler named Charles. Or for those of us who cannot up and leave are stress of everyday life: you can prevent your body from constantly being in the “alert state”. Though not undermining the importance of making positive changes to physically remove those stress, a much more viable intervention may be tricking your body into thinking you are not stressed.

How does one accomplish this? The ground breaking *eureka* moment that has taking the health industry by storm? Breathing. A recent study has shown that deep, mindful breathing, focusing on relaxing each part of your body, can reduce breathing and heart rate enough for your body to temporarily leave that “high alert” state. This process has actually been showed to be able to reduce pain levels in the body more efficiently than morphine. Don’t think your one to meditate? Simply sitting down and breathing deeply can still cause a small reduction in pain levels. Try 3 or 4 minutes of relaxed breathing a day, focusing on 5-6 seconds in and 5-6 seconds out.

The point is that pain is not what we think. It is complex, and changing, and no one fully understands it. Yes, there may be an issue with a muscle in your back. But addressing only the muscle (with exercise or medication) might only be addressing one of several factors contributing to your lasting pain. Imagine if the solution that we have been looking for is actually the most fundamental and basic principle of life: breathing. Take your 3 or 4 minutes of mindful breathing a day and consider it your chill pill.

For more information, visit and talk to our registered physiotherapist, Jenny Lee

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