Imagine being tied up where you couldn't move your limbs and having an itch on your shoulder that you couldn't scratch. Annoying? Frustrating? Impossible to deal with after 2 mins? Welcome to the world of the chronic pain sufferer.
Chronic pain is classified as pain that has gone beyond the length of 3- 6 months. Perhaps a better description is 'pain that has gone beyond the expected period of healing'. When you sprain an ankle, the recovery is 4-6 weeks. When you break a bone the expected healing is 2-3 months. Acute pain is pain that hurts when you move. It makes you wince when you extend beyond what the body is capable of tolerating. Its identifiable and explicable. Chronic pain is pain that sustains and is constantly present. It doesn't decrease with time, it doesn't get better with immobilising joints, it just 'keeps on keeping on'.
Conditions such as Fibromyalgia, Arthritis, Sciatica, Headaches and the oft misunderstood Chronic Fatigue Syndrome are all examples of chronic pain. It drains your energy, your patience and your ability to be cognitive. Imagine not being able to open a door to enter a room without assistance. Thiis the daily struggle from people who suffer from this type of pain. Complex Regional Pain Syndrome (CPRS) has become the new term to define this type of pain and research has proven that it not only exists but it can also be treated.
One of the most challenging statements for a chronic pain sufferer to hear is 'it's all in your head'. This indicates that there is no real pain present and that somehow a chronic pain sufferer is 'manufacturing' pain or symptoms for some psychological benefit. Anyone who has found no explanation for a condition from a medical professional and been given this lovely statement of diagnosis should turn around and walk away from the clinic!
A recent study in the UK has found that there is in fact a direct correlation to chronic pain that exists in the peripheral nerve pathways (nerves in the limbs and extremities) that are stimulated by 'auto-antibodies' in the blood itself. These antibodies can be present after something as small as a bee sting. Their presence in the blood may only be for a short period but they are there in this 'window of vulnerability' as it is termed by the researchers.
Whilst the pathway is not yet fully understood, the stimulus of the antibodies in the blood causes the peripheral nerves to misfire and thus pain is induced. Now these antibodies are not demons that will create conditions, but they are present. The research indicates that 'previous trauma' has to be present for inflammation to have occurred and thus the stimulation renders the pain response.
So people who have suffered conditions in the past, can still be suffering the pain responses for months afterwards. A particular condition of a friend sprang immediately to mind. She was on holiday in India at the beginning of a 6 week trek through the countryside and was bitten by a mosquito. Within days she was feverish, sweating, hyper sensitive to touch and any movement rendered her in agony. The diagnosis was a double whammy of Ross River Fever and an exotic condition called chikungunya virus. Her husband whisked her back to Australia and she has been suffering chronic, debilitating muscular pain and inflammatory responses for 3 years now. She has not been able to get a clear diagnosis from doctors or medical professionals and has resorted to Naturopathic and Chinese Medical treatments to manage her chronic inflammatory responses. Having treated her over these years, it is apparent that she has to be very careful with her activity and softer approaches such as lymphatic drainage, myofascial release and Acupuncture are all modalities that are able to provide temporary relief and pain management.
Brain training has also been cited as a way of managing CPRS although with some limiting results. Another client with a chronic hamstring injury is a large advocate of Brain Neuroplasticity was able to achieve some limited results from applying his 'neuroplasticity' to his injury. But his determination to adhere to his yoga practice is perhaps also to blame here!
Brain training can address certain measures of chronic pain as there is strong evidence to suggest that pain is simply a brain trained response. Phantom Limb Pain is another example where following amputation of a limb, the brain retains cellular memory and can still experience trauma in the 'phantom' limb. Obviously there is some involvement of the brain in pain. But this explanation, cannot explain ALL pain. So whilst there is a certain amount of management that can be influenced by the brain and the Central Nervous System, it is inconclusive for ALL pain management.
Treating people with CPRS is important. A sympathetic therapist will address the person and not the condition. A recent treatment had me baffled for 45min of a session whereby the client was simply unable to get comfortable from the throbbing in her arm caused by disc degeneration and consequent nerve impingement that was firing heat and pain along her Left arm. We tried everything, including different positions and modalities. Finally, I gave up being logical and went with intuition and palpation. We found an area of relief in her anterior scalenes (front of the neck) and light fascial work and draining her allowed her to relax and move her arm downwards without pain for 20mins. Sometimes you need to treat the person rather than just the condition.
Further development of research for treatment of CPRS and associated chronic pain is occurring and this line of investigation may make a huge difference to those who suffer daily with seemingly inexplicable pain and conditions. Whilst we understand much of what is happening with the brain and pain, we are still discovering new explanations and this will lead to new way to approach pain and seemingly inexplicable conditions.
