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What is Chronic Pain?

What is Normal ‘Protective’ Pain?

Normally pain is good. It informs you about potential or actual damage to your body’s tissues. Nociceptor nerve cells in the tissues of your body, react to strong stimuli such as pressure, heat, cold or chemicals.

These nociceptors send a message to the spinal cord, which then forward another message up to the brain. Your brain then processes these messages and produces a coordinated response to escape whatever is causing the tissue damage.

What is ‘Pathological’ Pain?

Research has shown that changes occur in your body at all levels of pain processing. These changes include:

Changes at the Injury Site
At the site of the injury, your peripheral nerve becomes much more easily excitable. This means that it takes far less of a stimulus to cause it fire off. In some cases, even a gentle brush against the skin is enough to fire off the pain pathway.

Unfortunately it is not just the damaged nerves that become more excitable, but also the neighbouring nerves, which means even further amplification of the nerve messages. Some nerves can also start firing off spontaneously, which means that they do not need a stimulus to fire off.

Changes in your Spinal CordIn the dorsal horn of the spinal cord, changes occur in some of the cells that receive the nociceptor messages. These changes lead to greater sensitivity to the spontaneous nociceptor messages mentioned previously. Changes can also occur in some cells that leads to a ‘memory’ developing between two cells, which leads to an amplified response in the neighbouring cell.

Changes in your Brain
Usually, your brain can decrease the level of pain you experience through releasing natural opioid hormones. When you suffer chronic pain, changes occur in the midbrain which actually increase the nociceptive messages. This means you’ll perceive even more pain.

Chronic pain messages stimulate parts of the brain involved in emotion, fear and feelings. This may help explain why conditions such as depression, sleep disorders and pain catastrophising are linked in with chronic pain.

We also know that chronic pain leads to atrophy or ‘shrinking’ of parts of the cortex and midbrain. Brain-stimulating activities may help to limit this ageing.

What is Sports Physiotherapy?

Sports Physiotherapy is the specialized branch of physiotherapy which deals with injuries and issues related to sports people.

Sports injuries do differ to everyday injuries. Athletes normally require high level performance and demand placed upon their body, which stresses their muscles, joints and bones to the limit. Sports physiotherapists help athletes recover from sporting injuries, and provide education and resources to prevent problems.

Each sports physiotherapist usually has sport-specific knowledge that addresses acute, chronic and overuse injuries. Their services are generally available to sports men and women of all ages engaged in sports at any level of competition.

What is Nerve Pain?

Nerve pain is pain that is caused by damage or disease that affects the nervous system of the body. It is also known as neuropathic pain or neuralgia. Nerve pain is a pain that comes from problems with signals from the nerves. It is different to the common type of pain that is due to an injury. This is known as nociceptive pain.

What Causes Nerve Pain?
Neuropathic pain is caused by a problem with your nerves themselves, which sends pain messages to the brain.

What are Nerve Pain Symptoms?
Nerve pain is often described as burning, stabbing, shooting, aching, or like an electric shock.

What Causes Nerve Pain?
Various conditions can affect your nerves and cause nerve pain. Common sources of nerve pain include:
  • Shingles (post-herpetic neuralgia).
  • Trigeminal neuralgia.
  • Diabetic neuropathy.
  • Phantom limb pain following an amputation.
  • Cancer.
  • Multiple sclerosis.
  • Chemotherapy.
  • HIV infection.
  • Alcoholism.
  • Other nerve disorders.
Nerve Pain & Nociceptive Pain
You can suffer both nerve pain and nociceptive pain simultaneously. Both pain types can be caused by the same condition.
Nerve Pain Treatment
Nerve pain is less likely than nociceptive pain to be helped by traditional painkillers such as paracetamol, anti-inflammatories and codeine.
However, other types of medicines often work well to ease the pain. Nerve pain is often eased by anti-depressant or anti-epileptic medicines. Please ask your doctor for more advice.

Sports Injury? What to do? When?

You probably already know that a sports injury can not only affect your performance, but also your lifestyle. The latest research continues to change sports injury management considerably. Our challenge is to keep up to date with the latest research and put them to work for you.How we treated you last year could vary greatly to how we treat you this year. The good news is that you can benefit significantly from our knowledge.


What Should You Do When You Suffer a Sports Injury?
Rest?
Rest from painful exercise or a movement is essential in the early injury stage. "No pain. No gain." does not apply in most cases. The rule of thumb is - don't do anything that reproduces your pain for the initial two or three days. After that, you need to get it moving or other problems will develop.

Ice or Heat?
We normally recommend avoiding heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. In traumatic injuries, such as ligament sprains, muscle tears or bruising, ice should help reduce your pain and swelling.

Once the "heat" has come out of your injury, heat packs can be used. We recommend 20 minute applications a few times a day to increase the blood flow and hasten your healing rate. Heat will also help your muscles relax and ease your pain. If you're not sure what to do, please call us to specifically discuss your situation.

Should You Use a Compressive Bandage?
Yes. A compressive bandage will help to control swelling and bleeding in the first few days. In most cases, the bandage will also help to support the injury as the new scar tissue is laid down. This should help to reduce your pain. Some injuries will benefit from more rigid support such as a brace or strapping tape. Please ask us if you are uncertain what to do next.

Elevation?
Gravity will encourage swelling to settle at the lowest point. Elevation of an injury in the first few days is very helpful, especially for ankle or hand injuries. Think where your injury is and where your heart is. Try to rest your injury above your heart.

What Medication Should You Use?
Your Doctor or Pharmacist may recommend pain killers or an anti-inflammatory drug. It is best to seek their professional advice as certain drugs can interfere with other health conditions, especially asthmatics.

What is Physiotherapy?

In simple terms, your physiotherapist is a mechanic for the human body. A physiotherapist is a university-trained medical professional who uses natural physical approaches to promote, maintain and restore your well-being so that you can perform and enjoy your chosen sport, work or everyday activities.

A physiotherapist's university training includes a thorough study of the human body, particularly the muscle and joint system. It involves studying anatomy, neuroanatomy, physiology, psychology, medical conditions, musculoskeletal conditions, exercises prescription and electrotherapy.

Physiotherapy is a science-based methodology that is constantly evolving as new research discovers better ways to treat your body. Your physiotherapist will use their extensive knowledge of the human body and highly-trained skills to help restore your aching, stiff and dysfunctional muscles and joints back to health.

Physiotherapists at Boyner Clinic are highly skilled in Sports, Musculoskeletal, Ergonomics and Spinal Injury Rehabilitation.