Pain Neuroscience Education may be the answer!
It is estimated that 144,000 people go to outpatient physical therapy everyday for low back pain and 110 million Americans suffer with chronic pain. It is undeniable that pain is an epidemic. What you may not know is there is a shift in the way we understand and treat pain. It has been shown that when healthcare providers explain the source of someone's pain with terms like ‘wear and tear’, ‘deterioration’, ‘crumbling’, ‘collapsing’, ‘bulging’ and similar descriptors it actually induces fear, anxiety, and depression. As more and more research has come out in the last decade or so it has been shown that the classic way many healthcare providers looked at and explained pain to patients wasn’t the full picture and in many cases contributed to the perpetuation of pain.
Did you know, if you take one hundred people and do an MRI on them, 40% will have a bulging disc in their spine, yet they experience no pain. One in three people over thirty will have some sort of rotator cuff pathology yet will not have pain or limitations, at age seventy it climbs to two out of every three people. Interestingly enough one in every three college basketball players has arthritis in the knee, and anywhere from 25-50% of people without knee pain have arthritis at the knee on MRI.
The above shows that you can have tissue damage without pain and you can have pain without evidence of tissue damage. Tissue health and pain are not the same thing. People may have had tissue damage that caused pain but this damage has healed yet their pain persists, they go to the doctor and get imaging studies and leave without an explanation for their continued pain.
There is now strong research that tells us how pain can become chronic, widespread, and even impacts things like attention, sleep, memory and fatigue. What is even more exciting than having research to explain how this can happen is the fact that there is now gold level evidence that supports pain neuroscience education (PNE) combined with graded and targeted exercises can treat patients struggling with many chronic pain conditions. Research even shows that if someone suffering from chronic pain actually has their healthcare provider explain to them how pain happens in a way that allows the patient to understand pain, then day one their pain, function, and fear all improve. Pain neuroscience education has actually been found to be far more effective in treating chronic pain than many of the medications prescribed to patients. For instance for every two patients taught PNE one will show improvements in their function. For every three patients taught PNE one will have improved pain. This may not sound impressive until you compare it to common medical interventions- for instance the medication Gabapentin which is often prescribed to pain patients is effective in one out of six, and antidepressants are effective in only one out of seven.
The world of pain and our understanding of pain is constantly growing for the betterment of the patients we treat. If you or someone you know deals with chronic pain you are encouraged to seek help from providers ready to treat your pain and conditions possibly through exercise and education.
