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Episode 24: Pain as Alarm

Video Highlights

​Hi, everybody.

Dr. Eric Cobb, back with you this week, and we’re going to talk about a very, very critical topic called pain.

Now the reason this is coming up, a lot of new research coming out, and one of the things that we specialize in, and have for years in Z-Health, is really helping people understand how pain works in the body, what its purpose is, and what you can do about it most importantly.

Pain science, as I said, has radically evolved in the last really 50 years, but now that’s it’s been filtering down in the last ten years, we know more and more and more about how pain is actually processed in the body, and in this evolution there’s some really important good news I want to share with you.

To get started, I’m just going to talk very briefly about how pain works in the body because right now I can guarantee that some people watching this blog are experiencing pain, or someone that they love is; and if that doesn’t apply to you – no one you know is in pain and you’re not in pain, still listen because at some point it’s going to matter.

Let’s get started with this whole idea of how pain works. Pain, as most people know, involves the nervous system of the body, and you have about 45 miles of nerves running through your body and they are connected like a superhighway system, if you want to think about it like that. So they’re transmitting and they’re cross-talking throughout the body.

All of these nerve carry a kind of a baseline level of electrical activity, so there’s a little electrical current that’s running through them all the time; and depending on what you’re doing, that electrical current can go up or down depending on the amount of stimulus that’s coming in – how hot it is, how you’re moving, if you’re sore, if you exercised the day before, etc.

Now, when it comes to thinking about pain, what I want you to understand is that your nerves act like an alarm system. If you have an alarm system on your house, you know that it’s designed for kind of the big problems. So if you set the alarm and someone comes up at night and they shake the door and pop it open, the alarm is going to go off, or if they break a window. Or if you have a motion sensor that’s set the right way and a human-sized person walks through then the alarm goes off.

Well, the nervous system is kind of designed like that, so your nerves have this electrical current baseline, and then depending on what happens to you the current level will go up. When that current level goes up past a certain pain, a threshold, that signal now goes to the brain and the brain has to actually be made aware of what’s going on so that it can take an appropriate action.

That’s the very first thing I want you to write down, is that when we feel pain what we’re actually experiencing is the brain’s need to take action on something. We tell people that pain is a threat signal or an action signal – something’s not right and we need to be made aware of it.

If you think about this, if you burn your hand, the appropriate action is first of all, get your hand away from what’s burning it and then take care of it. So you go, “Okay, I’ve got to run it under some cold water. I’ve got to look at it and make sure, and decide how badly burned it is. Do I need to put a sterile ointment and a dressing on it? Do I need to go see the doctor?”

Remember, the point of pain is to take an appropriate action. Pain’s a good thing for that reason; it helps us stay alive.

Picture of pain medication and an alarm clock.

Once we’ve taken appropriate action however, and the healing process has begun and has progressed to the point that we no longer need to be aware of it, pain should go away. In other words, what would happen is that pain signal in that nerve, it’s reached this threshold point, and once the action’s been taken it should drop back down to its baseline.

Here’s the hard part: one in four people, after their alarm system goes off, for some reason the signal doesn’t drop back down to baseline, it just turns off a little bit, which means that we have people walking around whose alarm systems are extremely sensitive.

Think about this. If you had an alarm system on your house, and instead of having to have the door open or the window broken for the alarm to go off, what if just a slight breeze, a leaf bumping against the window, was enough to set the alarm off? Well, in some people, that’s how their brain and nerves are now communicating, which means then, if that’s you, or if that’s someone you know, after that occurs, things that previously wouldn’t have hurt now cause pain. This is a process called sensitization, and we have to be really careful about it.

There are a couple of big take-aways from today’s little lecture. Number one: you have to understand that, once you’ve taken appropriate action, pain should begin to go away. So if you’re experiencing pain, you need to do the right stuff, which the first thing is consult your healthcare provider; make sure nothing bad is going on. But then, as long as you’ve been cleared and they go, “You know what? It’s just kind of …,” it’s a standard diagnosis of some kind – you’ve got a pulled muscle, you’ve got this, some swelling around a joint. If they cleared you for movement, you need to start moving because what happens is the less we move the more likely we are, in many cases, to have that electrical current problem.

If you think about yourself or something you know that had pain, and as a result of that issue have really never been able to get back into activity. Maybe they avoid things at work or they can’t help around the house or whatever, that is usually an indication that their alarm system has become hypersensitive, not that they’re injured more.

If you can take away one lesson and write it down from this blog this week, it’s a very simple phrase, and this is based off modern pain science, is that pain does not equal injury. Most people, when they feel a pain, they go, “Oh, something must be wrong.” Nope. All it is is an alarm signal from the nervous system to the brain. If you haven’t fallen recently and had some kind of trauma occur and you’re just having pain, understand that it may have nothing to do with an injury and more to do with some aberrant wiring and signaling going on.

The goal here is to not let that pain stop you from being active because one of the things that we know for sure is that physical activity, in almost all cases, is one of the best preventative medications, if you want to call is that, that you can take against pain.

With that in mind, next week we’re going to talk about what’s called graded exposure. As I said, it may be you, may be someone that you love that’s been having chronic pain for many, many years, and most of what I’ve talked on this blog is more about chronic pain than something acute like you’ve just burned your hand. So if you know someone that’s in chronic pain or has experienced that, next week we’re going to talk about this process called graded exposure. You can Google it and look it up. It’s a simple idea, simple concept based off what we’ve been discussing to help people move from pain back into the activities of their life.

I hope that you found this really valuable. It’s an incredibly important topic. It’s going to be an incredibly important topic for the decade to come as people learn more and more how to separate out the pain experience from healing so that we can get everyone as fit and healthy as possible for the length of their lives.

Please let us know if you have questions about this.

Anything we can help you with we’re happy to answer.


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