• Matthew Anstey MCSP HCPC

Chronic pain- why is your pain just not going away?


Does your pain make you feel like there is no way out?

Do you feel like it is controlling your life and preventing you from doing the activities you would like to do?


If you have had pain for long periods (over 12 weeks), sometimes known as chronic pain, then sometimes it is all too easy to slip into a vicious cycle. The more the pain you have, the less you feel you are able to do, and the less you are able to do the more your pain. If this sounds familiar then there may still be hope yet.

What can sometimes happen following a prolonged episode of pain is something called central sensitisation. This is effectively when the nerves which transmit pain are in a state of increased re-activity or hyperactivity, and this is common after someone has been in pain for prolonged periods of more than a few months. When central sensitisation occurs, these nerves send pain signals to the brain, even when there is no (or minimal) harmful cause for the pain (e.g. a stimulus like movement is more painful than it should be). This comes from the nerves changing their chemical makeup over a period when they are experiencing lots of pain, e.g. after an injury. Sometimes, even though the injury has resolved/improved, the nerves stay in this heightened reactive state, and so whilst the injury resolves, the pain remains very much the same, or even worsens. This can happen for any joint or area of the body.

Once this process starts, it can be tricky to break it on your own. You mind can start focussing on the pain and it can begin taking over your life. We now know that having negative thoughts and anxiety about your chronic pain, actually increases the sensation of pain even more.


The only way to alleviate these symptoms is to progressively encourage the nerves to de-sensitise over time, starting with some gentle movements, release and mobilisation that give the nerve some normal feedback, and gradually increasing the stress on the area as the nerves settle back down. The good news is that if given a proper chance, the nerve should settle really well and you should have a good outcome, the only issue is it does generally take some time, and you’ll need to work at it.

It is important to move your thought processes away from the pain, focus on small achievable goals and work towards them. Step by step, as you achieve these goals, negatives turn into positives and the pain begins to improve.

Fibromyalgia is one such painful condition where the nerves in the body transmit incorrect signals to the brain. The pain is real - your brain is receiving pain signals from these nerves, but the cause of the pain should not be giving you the level of discomfort you are experiencing.

I have just finished treatment with one such lady. She was tired of her pain taking over her life, controlling the activities she could and could not do, impacting her quality of life. This lady had Fibromyalgia. After a long chat about what happens with fibromyalgia, she has the confidence to start fighting back. We worked to progressively, and incrementally increase her tolerance to the stresses of everyday life. A bespoke exercise programme has got her from being fearful of her pain, to taking back control and she is now mastering her fibromyalgia, rather than it mastering her. With her new found confidence, she has been able to continue her rehabilitation without me, and continues to improve. All she needed was 6 sessions with physiotherapy over 6 weeks, and she now reports massive improvements in her pain, and confidence that her future is one where she is not a victim to her constant pain.

Be brave, there is usually hope for the future but it won’t come without some hard work! Take back control! You need to want to get rid of the pain enough that you are willing to start changing your thinking and outlook about it. Most importantly, you must have the courage and determination to try!


Check out www.tamethebeast.org which has a fantastic video explaining with some clarity, and in simple terms how chronic pain can take over, and more importantly, how to fight back.


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