What Causes Chronic Pain?


In our earlier blog, we defined what pain is and how it can be categorised into acute pain and chronic pain.  In this blog, we will focus on the aspect of chronic pain and some of the potential reasons as to why it may be occurring.

Chronic pain is pain that continues for longer than three months.

People suffering from chronic pain differ from acute pain because the immediate threat of an injury, or an incident that may be the source of the pain is no longer present. In chronic pain, there is a rewiring at multiple levels through the nervous system. These areas include but are not limited to the receptor, spinal cord and the cerebral cortex of the brain.

Looking at the pain gate theory will give a simple representation in regards to why people suffer from chronic pain, and why they struggle to recover. The pain gate theory was developed by Ronald Melzack and Patrick Wall in 1965 and describes what is occurring within the spinal cord.

Within the spinal cord, there is a neuron referred to as the wide dynamic range (WDR) neuron. This neuron is responsible for assessing the intensity of the stimulus as well as where it is coming from.

There are several other neurons that connect (synapse) to this WDR, and these include pain fibres and mechanoreceptors. As the name implies, mechanoreceptors are receptors that are stimulated through things such as pressure or movement. Both of these neurons connect to the WDR and activate it.

To illustrate this further, when someone hits their elbow, the first thing that most people do is rub that area. Hitting the elbow creates a painful response, and when you rub your elbow, there is a mechanical message sent to the spinal cord which inhibits the painful signal from getting through.

In this case, we are assuming that this mechanism is working appropriately. In the case of people suffering from chronic pain, there is a rewiring of this in the spinal cord, where even stimulating mechanoreceptors does not block the pain from activating the WDR and pain persists.

This is a very simplistic view of how pain is modulated but serves as a useful illustration to help people understand why their pain may not be improving in comparison to what other people experience.

Therefore, people who are suffering from this not only need to have the area of concern assessed but also look at the central structures that may have been impacted by the injury or event.

The management and treatment of Chronic Pain is multifactorial and always requires a multidisciplinary team.  Our collaborative team approach uses multiple skill sets and Ace Certified Practitioners who have experience solving even the most complex problems for our clients. Don’t put up with you pain, take action and call us today! If it’s pain, injury rehab or improved performance, Ace Clinics have a solution for you

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