The complexities of chronic pain are increasingly being studied and understood. In acute pain, pain and injury/tissue damage are to a great extent related: You cut your finger with a knife; special neurons called nociceptors register this information and send a message to the spinal cord and brain; you experience pain. However, in chronic pain, pain that has lasted for a long time, there can be a much murkier connection between physical problems and experienced pain. For example, researchers have found that many people with chronic low back pain do not have disc or other physical problems that can be identified as the cause of the pain, while many people with no back pain have disc problems and other physical changes. Whiplash sufferers may not have any identifiable physical problems.
As summarized by Todd Hargrove in his book “A Guide to Better Movement,” pain is a holistic experience in which information from many levels of the nervous system are put together into a whole. The purpose of pain is to signal danger and motivate protective actions. Move a limb with a muscle tear, it hurts, you move it less while it heals. However, in addition to tissue damage, all sorts of information from many levels of the nervous system can come into play in complicated ways, especially in chronic pain. There can be sensitization, in which the risk of danger is amplified with the result that pain is experienced. For example, nociceptors may send messages of danger into the spine and central nervous system for touch that in the past would have signaled pressure, not danger. Certain body positions or movements may be associated in memory with risk of danger. Sensations when moving a limb that had an injury in the past may trigger an evaluation of danger even when the injury has healed.
Many body-oriented therapists have applied these insights about pain to their work with clients. How central a role tissue injury plays varies from person to person. However, the general idea is that to the extent that sensitization or a person’s creation of meaning are involved in pain, lowering a sense of physical and other danger should be helpful. General relaxation and bodily pleasure outside the area of pain, examining the meanings associated with pain, slower movements that stay below the pain threshold and provide experiences of safe movement, and gentle touch, have all been used.
Citation: Todd Hargrove, A Guide to Better Movement: The Science and Practice of Moving with More Skill and Less Pain.
Paula Derry, PhD, LMT, is a bodywork practitioner at Ruscombe. She combines Shiatsu, a touch therapy based in Chinese medicine, with other holistic therapies to promote stress management, wellness, mind/body/spirit interconnectedness, and to support recovery from illness. She was for many years a research health psychologist. Visit her website..