Written by: Dr. Ashley Mak, PT, DPT, CSCS, Executive Contributor
Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.
One of the many things that separate us, humans, from animals, is our ability to feel pain and overcome it to achieve amazing things. Pain is an important sensation as it is there to protect us from further harm and maintain our wellbeing. However, experiencing pain for an extended period can have an impact on the quality of life.
One common theme amongst people experiencing chronic pain is the feeling of being “powerless”. As a community of entrepreneurs, we do not have the time to live this way. So the goal of today’s article is to share with you actionable strategies on overcoming chronic pain so that you can return to living the life you want, and help the people you are destined to help.
1. Get clearance from a doctor. Most injuries and pain will heal over time due to actual tissue injury and dysfunction. However, other problems can occur in the body (ie. systemically) which can cause pain. If the pain you’re experiencing is not influenced by movements, and paired with the following, then a check-up with your general practitioner is encouraged before taking any action: nausea or vomiting, changes in bowel or bladder function, fever, sweats, chills, unexplained weight loss or gain, or anything else that seems out of the ordinary since the onset of pain. These conditions paired with the pain indicate that there is something that is not just related to orthopaedics.
2. Understand what chronic pain is. There are three major stages of the pain cycle. Acute pain is the first stage when the initial injury occurs and lasts for about 6 weeks. This stage is either due to overuse or trauma, and the pain is associated with swelling, redness, and limited motion. The main goal of acute pain or injury is to protect the injured area and heal. Your main focus on recovery at this stage is to protect the joint and move within the pain-free range of motion. The pain-free motion will allow optimal blood flood, stimulate healing, and prevent joint stiffness. From weeks 6-12, you enter the subacute phase, where the majority of tissue healing occurs. At this point, movement is critical to enhance blood flow, prevent stiffness, and reduce pain. After 12 weeks, pain enters the chronic stage. The majority of tissue healing has occurred but the pain is still present. This is because at the time of injury, not only was the tissue in the process of healing but there are what is called “cortical changes” in the brain where sensation is processed. For the 12 weeks leading up to this stage, the electrical signals from the injured body part have been processed as pain up in the somatosensory cortex of the brain. This was used to serve as a reminder to protect the joint. As a result, the brain is conditioned to feel pain as a protective mechanism; in other words, the brain has a habit of perceiving painful stimuli. Most of the time at the chronic stage of pain, we are having repetitive irritation of the injured tissue, and the brain is used to feeling pain with everyday activities. For us to address this, we will follow the steps below:
3. Modify or eliminate the painful stimuli. We have to look at what was increasing or causing the pain in the first place. Most medical practitioners will focus on what “structures” or tissues are injured. Is it a joint? Bone? Herniated disc? Diagnosing the injured structure will lead to a plan of care. But as described above, at the chronic stage of pain there are not just tissue changes, but the brain itself is conditioned to feel pain in specific positions and actions. A tissue-specific approach is only addressing part of the problem. What needs to be done is to remove the irritating stimulus. If pain is still felt at 12 weeks and beyond, there are a series of activities and positions that are consistently irritating that area. Find out what they are, and either eliminate them or modify the activity so that the pain doesn’t get worse. For this to happen, we have to clearly define what feeling “worse” truly means. Symptoms and pain are worse if: the intensity increases closer to 10/10, the area of pain increases in size, the pain spreads further away from the spine (this is called peripheralization). This also includes the invisible factors found in stress management. If your body is under constant stress, you’ll carry it in your joints, but also, the elevated stress levels will increase your sensitivity to pain. You can reduce your stress by exercising properly and eating nutritious foods. Two other important aspects of stress management also include getting enough quality sleep and forming quality relationships.
4. Find the activities and behaviors that make the pain feel better and do more of it. In essence, these can be classified between positions and movements. Positions are static and movements are dynamic. Most of the time, if there are positions that make the pain worse, then there should be positions and movements that lessen the pain or “feeling better”. Signs that symptoms and pain are improving include a reduction in pain intensity (moves closer to 0), a reduction in the size of pain area, movement of the pain closer to the spine (centralization), and if there is an improved sensation of the injured area. This is going to take a little self-discovery. The best way to do this is to ask yourself constantly “is this making me feel better, worse, or the same”. It can be something as simple as sitting in a chair but even doing an ‘awkward’ stretch that feels strangely good. Find those things, and do more of them. The body and brain will like that.
5. Ask for help. The challenge with pain management is that it is an individual experience. There is currently no scientific lab test that can establish the amount of pain that you are feeling. As a result, pain relief can be a lonely journey. Not having a support system can make things harder and more challenging for healing. Communicate with your doctor, physical therapist, chiropractor, and friends. If you feel like you aren’t being cared for or getting the necessary care that you need, then search for another provider. No one ever deserves to be in chronic pain. Live life to your fullest by first breaking free from the chains of chronic pain.
Pain medications can help out by taking the edge off of the pain and providing a little reprieve from your suffering. However, this is only one piece of the puzzle. You are your own biggest advocate and taking the steps above can help you get one step closer to living a pain-free life.
Dr. Ashley Mak, PT, DPT, CSCS, Executive Contributor Brainz Magazine
Dr. Ashley Mak is a physical therapist, movement specialist, and pain management expert in the world of sciatica pain. After experiencing unrelenting back and sciatica pain as a Division 1 athlete, he was determined to help others live free of pain and receive the care they deserve. He built ifixyoursciatica.com in 2020, with a major focus on providing a platform for people suffering from sciatica pain who've failed to respond to typical treatments. Ashley has helped over 1000 people fix their sciatica pain without the use of medications or surgery. He is the host of the "Fix Your Sciatica" podcast that shares real actionable steps to manage this condition. His mission: empower others.
