Chronic Pain Neurology

Chronic Pain Neurology is about understanding how pain can affect our neurology, which affects our mood, thinking and behaviour. Here we will introduce what pain can feel like, some of the mechanisms pain triggers in our body, and what effect that has on us.

Chronic Pain is awful.

To have a diagnosis of Chronic Pain, you need to be in significant pain for most of the day, for most of the days of the week. To define significant pain, we include “I move differently, and or avoid doing some things so that I don’t hurt” when those are activities that most people would consider a normal non-painful thing to do. we include this aspect as some people don’t receive the feeling of “pain” in an “ouch” way or are able to explain how much it hurts.

Pain can be dull, ache, gnawing, cramping and heavy. It can also be sharp, hot, burning, shooting, stabbing, searing, and or cold. Pain can be itchy. Pain can be shallow, or deep. Pain can be repetitive, randomly acute, or persistent and unending.

Let’s take a condensed look at the Chronic Pain Neurology – how our pain changes our neurotransmitters, and how those neurotransmitters effect our perceptions, mood, and cognition.

Sudden pain will cause an adrenaline spike, which will raise your heartbeat and blood pressure. If you also have anxiety, this will raise your anxiousness and could trigger an anxiety attack. Repeat sudden pain can be traumatic, changing our behaviours and body chemistry.

Dr Glenn Patrick Doyle says "chronic pain IS its own trauma. To begin to understand how chronic pain impacts a human, you NEED to understand how the nervous system responds to ongoing, inescapable stress."

When we feel pain, whether it is consistent or sudden, we also route some endorphins and noradrenaline to managing pain and healing. This decreases the reserve of Endorphins and Noradrenaline.

Endorphins are used to feel happy, joy and contentment. Spare endorphins can be used to offset anxiety, while a dip in Endorphin levels will feel like depression or sadness. Endorphins are also used to help us feel appreciated and desired in social interactions, triggering the hormone Oxytocin. Higher levels of Endorphins and Oxytocin decrease the difficulty to make Dopamine, which helps us to think.

Noradrenaline helps us evaluate our safety, and initiate tasks. When our Noradrenaline is depleted, because it is managing ongoing pain, then it is hard to feel safe, which also increases Anxiety. As Noradrenaline decreases, we want to stop doing things. Back in the day, this would encourage us to rest and heal, but in this day and age, we feel depressed and incapable.

Ongoing persistent pain can interfere with our sleep, compromise our immune system, sensitise us to pain, increase our aggression and our reactivity to stimuli. It affects how we see people around us, making them seem awful and bad. It can change how we see ourselves. This, too, can be traumatic.

Literally, the presence of pain makes it hard for us to think, to feel happy, to socialise and to do activities.

That is good if we are hurt and will heal soon. It is terrible if the pain persists and so do all of those awful aspects.

Sounds pretty bad – but wait…

…there is a worse part.

If our adrenaline system keeps getting jolted by pain, because we sat wrong, or had to walk on damaged legs etc, then our body can get caught in a pain induced adrenaline loop. This can tax our bodies system, which can lead to Chronic Fatigue and Fibromyalgia.

We need to manage our injuries and pain properly. Knowing how to do this is complex. Your GP can help with average injuries, but you may need to see a pain specialist if you have chronic pain, a therapist to help manage mental health, and potentially a specialist for the cause of your pain.

At Joshua Davidson Therapy, we can advise you on which professionals would benefit you, review your medication to see if it is helping your mental state and neurology etc, and advice on if you need to see a specific kind of specialist for your condition.

You can book now to see us. We accept private and MHTP rebates. Talk to your GP about getting a referral and see if a MHTP is suitable for.