When we stop and think of pain many of us think pain is just pain. I have recently bought two books on how to “live” with chronic pain and to make the best life possible. Both these books introduced a concept that I was not aware of. I am sure the terms have existed for years in the medical field, but since I have been dealing with chronic pain I have not had a doctor explain it using these terms.
Did you know there are actually three types of pain?
1. Nociceptive pain which occurs if there is an injury such as a broken bone, appendicitis etc.
2. Neuropathic pain occurs when there is an injury or condition to the nerve system. A spinal cord injury or multiple sclerosis are a few examples.
3. Nociplastic pain takes place when the pain system has become sensitized. Nociplastic is the pain felt in fibromyalgia.
You can compare the three types of pain like an alarm system. Nociceptive pain takes place when the alarm system is working properly. In neuropathic pain, the wires of the alarm system are damaged and in nociplastic pain the alarm system has a total malfunction.
When acute pain becomes chronic – changes within the pain system takes place. These changes lead to central sensitization. In central sensitization the spinal cord becomes more sensitive to pain. Our pain system has now altered and become dysfunctional. How do doctors make comments such as “fibromyalgia is just a mental illness” is beyond me when there is proof that the nervous system is affected.
Living in chronic pain will eventually change the synapses ( nerve impulses passing from one neuron to another) in the brain. These synapses become so strong that we feel chronic pain without something triggering pain or without us even being conscious about the pain. According to experts we must reconstruct these synapses in order for the chronic pain to ease or change patterns. Fibromyalgia often leaves areas feeling sore and painful when there is actually no “injury” to treat. For example, I often have upper back pain. It seems to be a very problematic area since my fibromyalgia diagnosis. I can apply heat, ice and take as many pain killers as possible, but my brain still alerts me with chronic pain to that area. It is impossible to fix the area of pain because the problem does not reside in the body part anymore. Make sense?
Think of it this way, we learn to bike or even drive a vehicle. It takes practice. The more we practice the stronger those synapses in the brain become, Eventually it becomes second nature to get on a bike or drive to the store. Same concept happens with chronic pain.
I have not made it far into the book to explain how to deconstruct these synapses to help alleviate chronic pain. Is this where the idea of slowly working our way up to longer increments of time helps reconstruct these synapses?! I am hoping as I make it through the book, it explains how to do this. Many resources explain what needs to be done, but not how to carry out any strategies to make the changes happen! I will be sure to share in a later blog, what I have learned.
According to experts many doctors do not know how to diagnose or treat nociplastic pain. Nociplastic pain is a fairly new concept. When I conducted research to write this blog it was documented that nociplastic pain was only really mentioned and introduced in 2016! That is not very long ago. Many doctors often recommend opioids to their patients to treat chronic pain. However, it is noted that opioids are ineffective in treating nociplastic pain or could eventually lead to worsening of pain. Opioids are also known for making central sensitization worse over time.
No matter what the treatment route is this process will not happen over night. It takes commitment and dedication. A person cannot expect to take part in a week or two program and expect it to resolve. Long lasting pain improvement requires a long term plan which has to be followed to show improvement.
For more information on nociplastic pain and fibromyalgia visit the following websites:
FibroFighters 