We can all recognise that pain can often be associated with some sort of tissue damage and inflammatory response.
Such as when you have an acute episode of back pain when doing your last set of heavier deadlift, an inflammatory response occurs, which can contribute to pain sensitive chemicals and swelling. This inflammatory response is an essential part in normal tissue repair. Typically, all tissues repair with time and our bodies’ natural healing processes. So why can pain sometimes persist despite enough time passed to allow tissue repair?
There are a few reasons for this and for each person different contributing factors can be present.
The injured tissues (muscles, tendons, bones) may have repaired or healed, but are not yet operating in a healthy way. Such as when we have underused our muscles for a period of time resulting in weakness or muscle imbalance. As an example, this can occur if we stop exercising for a couple of weeks and our core muscles become weaker.
Sometimes we can change our posture to adapt to our injury (such as keeping your back stiff or avoiding bending) which can sometimes result in persistent postural habits that can overload even healthy tissues.
Sometimes our nervous system (our brain, spinal cord and nerves) can become over sensitised. Let’s explore this in more detail.
How does the brain and nervous system affect pain?
Pain is an output from the brain, not an input from the tissues. It’s not our tissues (torn muscles or discs) that create the experience of pain, but simply a message that comes OUT of our brain. We have nerves in our body that determine different sensations such as hot/cold, sharp, pressure (they CANNOT report pain). These massages tell the brain about the pressure/ temperature (such as: “I touched a hot stovetop” or “I stepped on a sharp piece of glass”). The brain then collects that information and quickly puts it into its data processing centre to decide “Is this dangerous? Do I need to let you know about this?” It bases this decision on many things, including what we see, the environment we are in, our beliefs, our emotions and our past experiences. The brain then may OR may not give the output as pain. Once the brain has decided that this sensation input could be dangerous, it quickly sends out a message of pain to alert you to change what you are doing. This message is very useful in protecting us from burning ourselves, cutting ourselves and damaging ourselves further. However, because the brain makes this decision to send pain out based on a lot of data in the processing centre, sometimes pain can be sent out as a message even though there is no real danger or damage.
Our nervous system can become more sensitive if we are under stress
So now you know the brain relies on input messages from your tissue, and these messages are sent along our peripheral nerves to our brain.
When we are stressed and have increased stress hormones in our body, our brain goes on high alert and listens to more incoming messages. So, in periods of stress our incoming nerves can send more messages and our brain can suddenly start paying a lot more attention to these messages.
When we are stressed, our muscles become tighter, we breath shallower and don't use the diaphragm muscles as much. This can also increase the load on the structures on your lower back, which can increase the messages to the brain indicating that there is something wrong.
If you have back pain and have been going through periods of stress, try this simple breathing exercise
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