Updated: Aug 11
Ack! How are we to know the difference and what if we are wrong? This is a serious question to ask.
Right off the bat I want to explain that this article is talking about chronic, persistent pain. Pain that has lasted more than 6 months and you've ruled out any red flags such as cancer, burst fractures, kidney stones, infections, cauda equina syndrome, etc. Also, your pain is real. Just because we are talking about how the brain has created more pain, it isn't just in your head.
The pain that remains is what we are talking about and it is important to ask the question to start the conversation about what neuropathic pain is. If you've read a previous article about how chronic pain starts, you'll have read that our awareness of pain sensations is a system that is designed to protect us. You'll also have read that the same system can become very over protective and actually change the neural pathways in our bodies and brains to become hyper vigilant to look for danger. Even when that 'danger' isn't actually a serious threat.
So how do we decipher if the pain we are experiencing is actual tissue damage or more neuropathic? Right away, the fact that the pain sensations are still there after 6 months shows that there is a percentage that is neuropathic. Tissues do have a healing time of 6-12 weeks, in fact most lower back pain will resolve itself in 2-6 weeks.
If there is a percentage of the pain coming from a neuropathic change, then working on that part will help.
What are the other factors that we look at when deciding how much of the pain experience is neuropathic?
Did the pain evolve slowly over a time of stress in your life?
Does the pain change, move to different parts of your body every so often?
If you go on vacation or to an enjoyable, immersive social occasion does the pain seem to not be there?
Do you have multiple serious conditions?
Have you lived through a traumatic life event in childhood or as an adult?
Higher levels of pain during high stress.
These are a few of the signs I would look at when we talk about your pain experience. If you'd like to take the quiz yourself, head there now and check it out. It is a quick 9 questions that will give you an indication.
So if your pain experience isn't all tissue damage and surgery/injections are not likely to 'fix' it... Then what? Well, the good news is that neuropathic pain is actually quite treatable. No drugs, no surgery, no injections. It can be super effective within 2-3 sessions and has lasting results. Sounds too good to be true sometimes. But I'll be honest, it is this effective.
In the Boulder Back Pain Study, 64% of the pain reprocessing therapy (PRT) group were pain free at the end of the study with that group remaining pain free after the one year point. In comparison, the group that was treated with traditional physical therapy was 20% pain free at the end of the study with only 10% pain free at the one year mark.
Just as much as your nervous system can become over protective, it can also learn to become calm once again and see the world/stress with a better lens of safety. When working with this therapy it is also good to know that this isn't about pushing through pain, which is likely one of your habits as well. It hasn't worked yet, so let's learn a different approach.
Are you interested in learning more about pain reprocessing therapy? When you work with me we always look at this aspect within your pain treatment. From the language we use to our mindset of stress and beyond. Looking at the bigger picture to get back to living life!