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  • Dr. Elliott Perkins

Pain & the Brain




Our bodies do not function perfectly all the time. They make mistakes, and these mistakes can lead to a variety of outcomes both good and bad. One of these things can be persistent pain.


I’m not talking about acute injuries. If you tear your ACL or pull a muscle, it’s probably going hurt. But our bodies should be able to repair themselves and feel better over time. However, the process and pathway of pain perception isn’t perfect.


If you’re feeling pain in your knee does it really mean that something is damaged and needs protecting?


That’s the general premise of pain – its our brain’s alarm bell. Its our brain’s way of saying “hey! I think something might be wrong, stop what you’re doing!”


This is obviously very valuable in most situations, but sometimes the brain over protects and sometimes there are false alarms.


Example Time!


When we lock our car, how many times do we have to press the lock button on the key fob for it to work?


Once. Just once.


But we’ve all either done this or know someone who presses the button like 10 times when they’re walking away from the vehicle.


Did the 9 times you pressed the button after the first do anything valuable for locking the vehicle?


NO.


The first time you pressed the button you locked it. that’s it. Everything afterwards was just noise.


Pressing that button multiple times is a behavior that’s developed over time.


Learned behaviours through observation


If you’re young enough and your parents had key fobs you may have witnessed them pressing the lock button several times to lock their vehicle, so you develop that behavior to mimic what your parents did.


Learned behaviours through personal experience


Or, maybe two years ago you forgot to lock your car and the next day you find that someone has stolen your things. So ever since then you have wanted to REALLY make sure that your car is locked.


These experiences can shape the way we behave. Our brain does the same thing for pain! It takes all these past and current experiences to help determine if its worth turning on the alarm when a body part senses something.


So people ask “how does being stressed have anything to do with my knee hurting?”

Under normal circumstances our alarm system works quite efficiently. But certain things can keep the alarm system on high alert. When we are stressed, our alarm system is on high alert. When we are lacking sleep our alarm system is on high alert. When we’re sitting at a desk/in a car/on our couch all day our alarm system is also on high alert because it hasn’t had any recent experiences to know that most movements are completely safe.


Just like how we can develop over-protective tendencies and locking your vehicle 10 times, your brain can develop over-protection for a physical part of your body, like the knee. It isn’t providing any extra value by doing this, and just because you perceive a greater intensity of pain doesn’t necessarily mean that there is anything more serious going on. It could just be your brain pressing that lock button 9 more times than it needs to. sometimes it’s just noise.


How do we change this?


If we want to stop pressing the key fob 10 times when locking our vehicle, having someone just tell us usually isn't very helpful. Imagine being told to “stop being in pain”. But with conscious effort, activity, and the proper mindset, we can make change.


Small, attainable changes can be made at first, and it might be uncomfortable not to be able to press the button a few more times in the early stages. It takes time to re-adjust, it takes time to re-learn, and it takes time to modify perception and behavior.


If you are unsure where to start and you feel like you’ve been dealing with long term pain or discomfort, feel free to reach out to me, and I will do my best to point you in the right direction for more learning resources, or provide professional help.

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