PART 2: Managing pain when your surgeon says an operation wont help.
We’ve previously talked about how weight may contribute to knee pain. But, maybe this isn’t you – are there other factors that you can influence? I’m Shelley from Miami Physio and Lakelands Physio and I want to explain how some other factors may be making your pain worse.
So, other known contributors to pain include lifestyle factors- such as social well being, and your mental state. “What? How does my social life and mindset contribute to my pain?” I hear you ask.
To explain this, I have to nerd out on pain science here first, so bear with me….
There are cells in the nervous system called Glial cells. These cells make up more than one half of the volume of the central nervous system. We used to think these cells were just packing cells, like those polystyrene bits that protect your parcels in the post! But actually, we now understand that these cells communicate and influence the nociceptive – or pain receptor cells. If the glial cells get excited they increase the sensitivity of the pain receptors – that is they make pain feel worse. So your 3/10 knee pain, might now feel like 9/10.
So what ramps up the glial cells. Stress, mental trauma, anxiety are all good examples. This could be in the form of bad news, an emotionally traumatic event, negative self talk or just a stressful day in the home or office.
We often notice this with patients when they have been progressing well and suddenly their pain is flared up without any physical event, but rather some sort of stressful situation. Or, there is a pattern of pain, which is not matching physical movements. An example of this is a patient with back pain who can sit for hours whilst doing something they enjoy, but when at work in a stressful environment can only sit for 30 minutes before their pain flares up. They’ve tried all manner of seats at work! Perhaps it isn’t the seat, but rather the stress ramping up the glial cells and therefore increasing their pain response.
Is this sounding familiar to you? Keep watching to learn how to turn the pain dial down.
Just as glial can increase pain perception, if you can dial the glial down, you can down regulate your pain perception. How do you do that??
Find the joy.
If you can calm your farm, and find a way to manage your stress or anxiety, you can switch off those glial cells. How you do this may be different for everyone. But some things you can try are:
- Doing an activity that you enjoy. Be it reading, getting outside, meeting up with a friend. Whatever gives you joy.
- Breathing exercises such as 4 and 6 breathing – breathing in for 4 seconds and out for 6, repeating 10 times, can help to reset the nervous system.
- Even just recognizing the trauma, or situation that is contributing to your heightened pain perception, and understanding that your underlying pathology is not worse, but your current sensitized pain receptors are making it feel worse, can help to turn off those glial cells.
So if you have pain that doesn’t seem to always match a mechanical (or movement) pattern, or perhaps your doctor has said surgery won’t fix your pain – try working on those pesky glial cells and see if you can decrease your pain perception.
If you would like some help, give us a call at Miami Physio or Lakelands Physio and we can help you work out a strategy for managing your pain.