PAIN: Have you ever heard of the Reactive Pain Alarm

What if I told you…

…that pain is actually good for us? This might sound odd but it is 100% true. Since many of us have negative connotations with pain, it can be lost on us that our pain system is an efficient and vital response that can be life-saving. Pain is like an internal alarm that alerts us to danger and motivates us to take action and stay safe. Sometimes this means we must stop and rest, like if we roll an ankle while running. In other scenarios, it alerts us to spring into action, like when we cut our finger with a knife. This is a wonderful and protective system that we all have and is based on instinct and our need to survive.

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Many pain experts use a fire alarm as an analogy for persistent pain because it can be applied  universally and is easily understood.

A fire alarm detects smoke and will warn you of a fire. The sound it makes is noisy and irritating, but this is to get your attention! Similarly, pain will let you know initially when something is wrong and this is incredibly protective and potentially life-saving.

 

But what if the alarm kept sounding…..after the threat, as in there is no smoke, no fire……..and you are far beyond any risk of danger?

 

Your fire-alarm has now begun to glitch and will likely be set off far too soon.  Has this ever happened to you where your fire alarm has gone off unexpectedly, for example, while making toast? Kind of annoying right!? Absolutely no REAL damage to the house or threat to those inside, just a burnt toast and A LOT of noise and commotion!

 

In this example, however, we see the fire alarm malfunction even further. Imagine lighting a candle-lit bath and are about to relax but you are interrupted again by the obnoxious fire alarm. You were just trying to find peace and quiet!!! How could the alarm go off now? Almost NO smoke, and very little danger! Once again, you are interrupted, and must take action to stop the alarm from sounding. Understandably, emotions of frustration and anger are mounting.

 

A reactive alarm will interrupt dinners, birthday parties, prayer ceremonies, and much, much more – even when there is no risk of smoke or fire.  What’s more, the hypersensitive alarm could signal at random or not stop ringing at all despite all attempts to alleviate the situation.  What would you do if the alarm bells in your house kept ringing? Keep in mind, alarms don’t tell us how MUCH smoke there is nor do they tell us if there is even a fire.

 

Bottom line -  the long term pain alarm, like the faulty fire alarm, is NOT a good alarm, meaning it is disconnected from the initial problem. Pain is felt sooner with less load, pressure or stress placed on the body.  As pain persists it becomes less about tissue damage and more about an overwhelming number of complex drivers for pain. Just like the fire alarm sounded after a candle was lit, a sensitive nervous system will sound the alarm bells too soon due to a lowered threshold. In some, the alarm, and accompanying distress and unease, never stop.

 

So, what can be done? The primary strategy is to help the system become less sensitive and to consider the complex triggers for every individual.  The good news is the pain and tissue damage threshold can change!  The life of a sensor is short and can only live for a few days and then they are replaced by fresh, new sensors. This means that your sensitivity is continually changing and sensitivity is not fixed.

 

Finding the right recovery strategies will be different for everyone.  Typically, low impact exercise that incorporates breathing and mindful movements are the ideal starting points for those with long-term pain.  Activities of this nature may include meditation, visualization, mindfulness, deep breathing, walking, swimming, thai chi, yoga, gentle stretching, and light resisted exercise, to name a few.

 

For more information regarding the sensitive nervous system, get in touch with a member of our physiotherapy team at Rehab1!

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Kate is from beautiful Bayside, N.B and has lived in the Saint John area for five years. A graduate of Dalhousie University’s School of Physiotherapy, Kate holds two degrees – a BSc. Kinesiology and a MSc. Physiotherapy. Known for her passion and authenticity, she brings an abundance of knowledge, experience, and commitment to the treatment table.

Since graduating, she has practiced in a variety of settings and is busy every year completing post-graduate training to incorporate the latest evidence-based treatment models. These courses include advanced training in neck, lower back and pelvic dysfunction, concussion/post concussion-syndrome, vestibular rehabilitation, persistent pain presentations, and female urinary incontinence.

Outside of her practice, Kate is heavily involved in the boxing world at KV Golden Gloves, and has recently implemented the “Fight Back” program for individuals living with Parkinson’s Disease. Here she challenges the class to reach their potential while learning real boxing skills. Similarly, you can find Kate coaching the Kings Way Care Senior Centre residents every other Thursday morning!