Persistent pain frequently asked questions

Q: Will my pain ever go away?
A:  New neuroscience information helps us understand pain very differently. We are now beginning to use the term persistent pain, rather than chronic pain, specifically because the term "chronic" implies a condition that won’t go away, and we now understand that pain is something that is very changeable. Persistent pain is a more accurate term for a condition that continues to be troublesome, but that can change and improve. 

We now understand that pain is produced in the nervous system and the nervous system is constantly adjusting and changing. As you begin to focus on a return to normal activity, your whole nervous system adjusts to a new, healthier state of being and gets less stuck on producing pain. Gradually, your ability to live your life increases, while the pain quiets. This is a process, so be patient with yourself.

Q:  I’ve been told there’s nothing wrong with me. Why do I still have pain?
 A: First, it’s important to understand that pain is the brain and nervous system’s  response to some kind of threat. At the time of an injury, or a change to our body’s tissues, the brain and nervous system create a pain response to let you know that there is potential harm and you should pay attention and take action.  That’s normal and healthy.  

With pain that lasts a long time, the physical body can heal, but the brain and nervous system have become accustomed to–and really good at–producing a pain experience. Your system has become too good at protecting you. So you can continue to experience very real pain, after an injury has healed or when there has not been any tissue damage.

Q: Will exercise/activity make my pain worse?
A:  Exercise has been shown to reduce pain levels by releasing endorphins, which are natural substances in the body that relieve pain. In addition, numerous studies have demonstrated the benefits of regular exercise and activity for improving heart health, increasing blood flow to muscles and other tissues, decreasing body fat, and improving energy levels and quality of sleep. A physical therapist can prescribe appropriate exercises for you.
  
Q:  Should I be worried about my bulging disc?
A:  A bulging (or herniated) disc is a very common process in the body that occurs as we age. Most adults have some degree of disc bulging, and many people have no symptoms at all. Even if you do have symptoms associated with a bulging disc, most normal activities are safe. A physical therapist can prescribe specific exercises to address this problem.
 
Q:  What is safe to do when I have pain?
A:  The most important thing to remember is that pain does not always mean injury or harm. Performing gentle motions on a regular basis will improve your overall function. Begin with small periods of activity (five to 10 minutes) and frequent rest breaks. Vary the activities and slowly begin increasing your time with these activities (five to10 minute increments).

Q:  What about if I have fibromyalgia?
A:  Often, during a fibromyalgia flare, patients have increased muscle pain with excessive activity or specific tasks like bringing something down from a shelf. This is not something to be afraid of, but it’s important to know how to gradually increase your activity level. First, you need to know what you are able to do without a flare-up. For example, can you set the table if you take one plate down off shelf at a time? Then gradually build up your activity. For example, use light one- to two-pound weights to improve your strength doing the same motion until you are able to bring two plates down from the shelf at a time to set the table.

Sometimes patients hear the message to avoid activity to avoid pain. This actually will lower your tolerance over time even more and make you more painful with more activities. It's best to find what you can do and build from there. A physical therapist can help gauge your ability and help you set goals to get back to function.