Pain Introspection

By | February 5, 2016
Relatively speaking, I haven’t made a lot of bad decisions or done a lot of crazy, ill-advised things in my life. I’ve always been the type to follow directions, do what you’re told, and respect authority, which I think is predominantly a good thing. No one is perfect, though, and it also helps to be proficient in handling the failures and not-so-proud moments.
The challenge for me is that, as a life-long perfectionist, the imperfect moments have probably created relatively amounts of guilt, shame, and disappointment than the might for someone else. The more I reflect on this the more aware I become of the damage that can be done by these unfortunate emotions, the results of needless perfectionism and pressure, coming both internally from within myself and externally from society. Left unaddressed, this emotional baggage can manifest in ways that one might not intuitively expect and even result in physical ailments, movement restrictions, and pain.
It is amazing how prolific our brain is at protecting our bodies at all costs. The human brain must have really been a student of Maslow’s hierarchy of needs when it was growing up…or rather, evolving over thousands of years. Even in cases of no real danger, no measurable “pathology,” if you will, our bodies can do strange things to protect against a perceived threat, especially when overly sensitized or when dealing with a scenario that has a history of causing pain or danger. When it comes to pain, it’s all about what the brain THINKS is happening…even if it might be wrong.
None of this is to say that no pathologies are real and/or that all pain and discomfort is fake. However, I think it’s an important intellectual progression that science is making to understand that A) pain is a protection mechanism, B) pain is created in the brain by the brain’s choice, and thus C) it’s possible to experience pain or restriction when no real harm has been done if the brain perceives a threat based upon the sensory inputs provided.
Upon this discovery, my first thought was to “bucket” any pain event in either the “real pain (pathology or injury)” bucket or the “fake pain (needless protection by the brain due to a perceived threat that wasn’t really even a threat)” bucket. Many times, however, pain events are driven by a complex cocktail of multiple stimuli, and as such, a little of both, and/or something else entirely, may be true. Perhaps you did injure your ankle a little but the body goes overboard in protecting a small injury. Perhaps later the tissues have perfectly healed, but your brain is still overly protective; maybe it doesn’t yet believe the ankle is healed or simply decides to protect against future injuries, thus pain and movement restrictions persist beyond their useful life. Or perhaps you’re dealing with emotional trauma, and the brain decides to create pain and/or movement inhibition as a distraction mechanism to avoid experiencing the emotional pain instead (see John Sarno’s work for more on this).
As luck would have it, after pondering this subject over the last week, I stumbled upon this video today. It describes a study put forth to measure and analyze spinal loads under different emotional circumstances using some sort of cool, fancy technology. They asked each subject to perform some physical tasks under two scenarios, one where the experiment administrator was very kind to the subject beforehand to set up a calm, happy atmosphere, and another where an unfriendly, stressful situation was created just before the task. This simple variable was able to create significantly different physical load pressures on the spine…for some people.
As it turns out, part of the population showed almost no physical difference between the two emotional situations. Others, however, showed vastly more load force placed upon the spine under the emotionally stressful circumstance. They then were able to identify, through personality questionnaires and tests, that those who showed more load under stress were primarily the introverts and the more sensitive personality types. The extroverts and less sensitive people, for the most part, showed little change.
Essentially what was happening was that for introverted and/or sensitive people, the emotional stress altered their biology and made their muscles more guarded and inhibited. This protection mechanism by the brain essentially heightens muscle tension in specific areas to discourage function and protect them from engaging in what was perceived by the brain as potentially dangerous behavior. Trying to perform the same task now became a little bit like trying to drive a car with the parking break on. But since they were required to perform the task for the study, they did so, and their performance dropped, and the load on their spines increased. The muscles performing the task were fighting against the muscles that were guarding and inhibiting function. This infighting of the musculature created even more load on the spine, more than can be accounted for simply by the exertion of the exercise.
Because of studies of this nature, we can see how the emotional response itself can inhibit function and create tension and possibly pain that is unwarranted. In the same token, however, it is also quite literally creating more actual physical stress on the body and could result in real tissue damage and physical injury. So what may have been “all in their head” could wind up creating physical injury as well.
I’ve learned a number of things from this study along with my own experiences as of late. One is that trying to understand and/or improve health isn’t about one view or one field over another (physical/emotional, alternative medicine/modern medicine, real/fake, etc.). Any reductionist approaches are often futile in learning or improving a situation. We have to understand how they all work together and have an open mind to all possibilities.
Firstly, understanding or improving health isn’t about finding the “right” method, it’s about understanding all of them and using each tool as needed to provide the right outcomes. The more you dig the more complex you realize things might be. Any reductionist approach can often be futile in understanding and improving the situation. We have to understand how the pieces work together and have an open mind to all possibilities.
Secondly, it’s important for us to be sensitive to anyone that seems to have pain or dysfunction that’s “all in their head.” It may be true that a person is in pain without having any physical damage, but that doesn’t mean they’re necessarily faking it (though it is still possible for people to fake pain, but we’ll leave that for another discussion). We can’t completely discount these situations and just write someone off as hopeless or difficult; they simply require a different approach to solving their problem.
Additionally, it becomes very important to know yourself and your body and have awareness of what’s going on while participating in certain activities. If you’re an introverted, analytical sort, for example (raising my own hand here), it may be prudent to skip an aggressive workout on a day where you are dealing with lots of emotional overhead. A light workout may help clear your mind, but jumping into max deadlifts could be ugly.
Lastly, I think simple education of this newly developing model of pain goes a long way towards helping everyone understand pain and injury, or lack thereof, in a deeper, more profound way that is more likely to resolve the situation. Just by knowing pain is a choice by the brain, albeit an unconscious one to our active thought, can help get a handle on pain, especially chronic in nature, and improve the chances of rehabilitation. As is usually the case in life, when we find paradoxes or hopeless situations that seem destined to be written off as craziness, there is always a clearer understanding when we look hard enough and keep an open mind for something unexpected and sometimes even unintuitive.

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