The pain experience described so far is what happens in acute pain. Acute pain is short lasting (up to 3 months) and is your body’s normal response to tissue damage (sprains, surgery). When pain lasts longer than 3 months, it becomes persistent (or chronic).
Unlike acute pain, chronic pain is long lasting (more than 3 months). Chronic pain may begin after an injury but tissue injury is not the cause of ongoing pain. This is because tissue healing from injury is usually complete by 3 months. Chronic pain is less about tissue damage and more about having an highly sensitive pain alarm system.
Imagine…
The human body as a house and chronic pain as a smoke alarm that keeps going off. When the alarm turns on, your natural reaction is to look for a fire. If you search the house and do not find a fire time after time, you need to check the alarm itself. Maybe the settings are too sensitive and it picks up other activities in the house (e.g. footsteps). Like a smoke alarm that goes off with no fire, chronic pain is more about having a highly sensitive nervous system sending pain signals to the body than tissue damage.
What is happening in the body?
Neuroplasticity is the ability of the brain to change over time. The pattern of connections between brain areas can become like a well worn path. Brain connections are like paths through fresh snow. When you use the same parts of your brain together, and they send messages back and forth the same way over and over, it is like creating a faster path. When you are starting a new strategy or doing something new to manage your pain, it will be like making a new path through the snow.
Neuroplasticity happens throughout your whole life, not just as children/teens. Anytime you learn or experience, or remember anything, you are changing the connections in your brain. Sometimes this is referred to as “what fires together, wires together” – the parts of the brain working together communicate more quickly over time.
It takes time to make new paths. Like walking through deep snow, it isn’t easy! Even when you lay down a new path, sometimes it “snows” and you need to go over it again. But, over time, you can make new connections and go down those pathways more easily and quickly. When a path is already there, when a brain area has already been connected to another area in a new way, then it becomes easier to use that pathway.
For example, if every time you have a burning or aching sensation, your thought is “ow! This is awful. I hate being in pain”, then that thought is connected strongly in your brain to the aching sensation. It is easy for your brain to follow that pathway. But if you start thinking a new thought, like, “this aching is uncomfortable but it isn’t dangerous” then over time that may become a more automatic thought pathway.
