About Chronic Pain

Chronic pain conditions are one of the greatest barriers to quality of life, affecting almost half (43%) of the UK population and the most common cause of disability.

Chronic pain can also lead to mental health problems such as anxiety, depression and sleep problems and often these issues go hand in hand and require treating the whole person with an integrative approach. Chronic pain can disrupt hobbies, family and relationships, work, energy levels and passion for living. Yet chronic pain is often poorly understood and poorly treated by standard drugs or surgery alone.

The Pain is the Brain too

When pain goes from acute to chronic, the pain isn’t just in a specific body part any more, the pain messages and signals also become wired in our brains and our nervous systems. Chronic pain creates a constant stress burden and increases what is called our allosteric load, our total body and brain stress burden, and uses up mental and physical resources, energy and can lead to a hyper aroused ‘tired but wired’ nervous system that has trouble relaxing and calming down due to the constant internal threat of pain.

It is possible to treat chronic pain effectively using a holistic approach even if the cause of the pain has no permanent cure.

Types of Pain

Chronic pain can be from many sources and causes including:

• Neuropathic or nerve pain-where the pain is in the nerve itself such as after a direct injury to a nerve or from a process like diabetes (diabetic neuropathy)
• Somatic or body pain– from a muscle or skeletal system/soft tissue or joint–like in arthritis or muscular pain
• Central sensitivity Pain-where the brain’s pain networks become so sensitive that even non-painful things start to register as pain in the brain, such as in complex regional pain syndrome and other chronic pain disorders where the pain becomes widespread due to the nervous system becoming confused as the origin of the pain and the area of pain increases and becomes painful more often, sometimes without a discernable pattern of what makes it better or worse. This type of pain is difficult to treat and often patients are not listened to or told they are exaggerating which is both false and detrimental to treating the pain effectively. This pain type, however, can be treated effectively with a holistic individualized approach.
• Neuropsychiatric pain-where there is a brain stress network component in addition to a physical component, such as in tension headaches where stress, anxiety and fear brain pathways can worsen the muscle tension and spasm in a vicious cycle and can include feelings of mental anguish and suffering on top of the physical tension pain. This type of mental + physical is just as real as physical pain from an acute injury. Despite well-meaning advice you can’t just ‘ignore it.’ It must be likewise, treated using a holistic approach.

The Endocannabinoid System & Pain

The endocannabinoid system is a natural brain and body system involved with regulating most major functions including pain regulation. There are ECS receptors in the brain as well as in nerves throughout the body and even in localized joints and tissues. Therapeutics that work on the ECS can interrupts the pain messages through a multitude of different chemical and brain messenger pathways, contributing to an anti-pain effect. ECS differences in chronic pain can change not only how our brain processes pain, but also our emotional and behavioural ‘brain reactions’ to it.

This is part of the chronic pain experience where our brain areas of emotion and mood become involved in the pain response. This is a very real part of chronic pain and ‘thinking positively’ does not work to counter it. Targeting the ECS helps with the secondary symptoms of pain too, such as low mood, anxiety, brainfog and anxiety.

Exercise also activates the analgesic (pain relief) effects of the endocannabinoid system, which is one of the reasons why staying active is so important if you have chronic pain. However, for many patients they are in too much pain or too deconditioned to be able to use exercise in this way, leading to a vicious cycle of no exercise, more weight gain & weakness, leading to more pain and muscle wasting making it harder to exercise/move the body leading to less energy. Treating pain effectively using a holistic approach can help break this cycle.