Are you struggling with Acute or Chronic Heel or Achilles pain? If so, you're not alone. In fact, chronic pain affects up to an estimated 1.6 million Australians, making it one of the most common medical conditions in the country. But why do some suffer more than others? Understanding the science behind why we experience pain can help us find better ways to manage it. In this blog post, we'll decode the pain cycle and explore the best evidence for recovering from chronic Heel and Achilles pain.
The Science of Pain: Understanding How It Works from Body to Brain to Body
Pain is a complex sensation that is essential to our survival. It is our body's warning system that tells us something is wrong. The process of pain is initiated when the nociceptors in our body's tissues are activated. Nociceptors are specialized receptors that detect tissue damage or inflammation.
The process of pain can be broken down into five steps: transduction, conduction, transmission, modulation, and perception. During transduction, the nociceptors convert the physical energy of tissue damage into electrical impulses that travel through the nerve fibers. The nerve fibers then conduct these impulses to the spinal cord, where they are transmitted to the brain.
In the brain, the impulses are modulated by different sensation and memory centers, before being perceived as pain. The perception of pain is influenced by a range of factors, including genetics, lifestyle, environment, and experience. This means that some people may experience more pain than others for the same injury. How weird is that!?
For example, people who suffer from plantar fasciitis or Achilles tendonitis may experience excruciating pain due to chronic inflammation in the affected tissues. The perception of pain can also be influenced by our emotional state and mental health. Chronic pain can often lead to depression, anxiety, and even disability, driving up pain perception and making the cycle worsen. Leading to a continuation of decreased activity, decreased capacity and ongoing frustration and performance decline.
The good news is that there are evidence-based strategies that can help alleviate acute and chronic pain, such as Physiotherapy, Tailored Exercise Protocols, and certain medications (when used correctly) can help reduce inflammation and promote healing. Psychological therapies like cognitive-behavioral therapy (CBT) and meditation can also help reduce the perception of pain by working to address the mental state around pain and in conjuction with rehabilitation, allow the body to get the best out of the tissue that is under it's cycle.
Factors That Influence Pain Perception: Injury History, Lifestyle, Environment and Experience
Injury history is a major influencer on how pain works in the body. How an injury was created and addressed will affect how it heals and the length of time it takes to heal. But like anything, there are exceptions to the rule.
When addressing injury and pain to start, open communication with healthcare providers and having a plan in place to enhance personal education, exercise, and supportive braces can aid in a quicker recovery process.
Lifestyle factors, such as diet and exercise history, health status (such as diabetes, obesity, heart and lung disease, smoking), and mental state, also play a significant role in the body's capacity to heal. It has been shown and proven that maintaining a healthy lifestyle can improve pain perception and the body's recovery process. Almost like you are always priming your body to be at its best.
The external environment of a person also plays a key role in how pain and injuries impact recovery. Location, access to healthcare, education, and personal support networks are all factors that can influence recovery time. As they equip you to assist the body and fight for the healthiest version of what your body can attain.
Experience with pain and recovery can also affect how pain is perceived and the length of time it takes to recover. The mind-body connection is a powerful tool and a positive attitude towards recovery can aid in a quicker recovery process, especially if you have overcome similar episodes before.
By taking these factors into account, a person can prime themselves for a higher likelihood of success in the recovery process. With the right equipment and support from practitioners with education, exercise, and manual therapy, as well as the correct medications, pain perception and recovery can have improved outcomes for all pain types and durations.
Acute vs Chronic Pain: When Pain Lasts More Than It Should
When we think of pain, we often imagine it as a temporary discomfort that will go away as soon as we heal from an injury. However, some people experience pain that lasts much longer than expected, leading to chronic discomfort and frustration.
Acute pain, which is the result of tissue damage, is usually thought to last anywhere between 8 and 12 weeks. After this time, the body may move into a chronic inflammatory cycle, which perpetuates the pain.
But why does this happen?
Several factors can impact the duration of pain, including:
- Adequate Rest: Allowing your body to rest and recover is critical to reducing pain. Overdoing activities, not finding the time for sleep or downtime away from life, can worsen inflammation and exacerbate your symptoms, particularly when your body is in a state of stress and pain.
- Avoiding Aggravating Activities: Similarly, it's important to avoid activities that worsen your pain, especially during the acute phase of recovery. Many people work through pain and this sets them up for pain to last and injuries to take longer to recover than they should
- The Correct Exercises for the Phase of Recovery You Are In: Depending on your injury, specific exercises may be necessary to strengthen and mobilize the affected area, stimulating it appropriately and allowing it to heal properly.
- Education on Pain and Relieving Strategies: Understanding pain and how to alleviate it is key to reducing its impact on your life. Learning relaxation techniques, pain-relief exercises, and mindfulness practices can all help. Also, the use of adjunct therapies such as compression, ice, elevation and assisted braces like "The Sever's Sleeve" are common tools that people can call on to build a strong foundation of healing and change.
- Severity of Injury: Most times, the severity of your injury will be the key factor in how long the pain lasts. However, many people experience long periods of pain after smaller injuries, too. Usually due to the combination of all things we have mentioned in this post.
- Your Brain's Fixation on Pain: Finally, research has shown that our brains can become fixated on pain, creating a vicious cycle that perpetuates discomfort:
When these factors combine, they create a cycle of pain that lasts longer than it should theoretically for most musculoskeletal injuries. By addressing these issues through adequate rest, avoiding aggravating activities, exercise, education, injury severity, and focusing on mental well-being, you can help reduce your pain and prevent it from becoming chronic.
Coping with Your Pain: The Best Evidence-Based Strategies for Recovery
If you're someone who experiences chronic pain, it can feel like there's no end in sight. You might feel helpless and frustrated, and the pain might rule your life. But there are ways to take control and manage your pain effectively. Here are some of the best evidence-based strategies for recovery:
- Cognitive Behavioural Therapy (CBT): This type of therapy can help you identify negative thinking patterns and develop effective challenges. By changing your mindset, you can change the way you experience pain.
- Therapeutic Manual Therapy and Exercise: Exercise is an important tool in managing chronic pain. By engaging in regular physical activity, you can improve your physical function and decrease pain complaints. Often therapists will use manual therapy techniques such as massage, joint articulation or acupuncture/dry needling to change the state of the tissue that is impacted and build a new profile of how the body works and heals over time.
- Assistive Devices: Assistive devices can reduce stress on joints and improve overall function. Devices like braces and crutches can be helpful for individuals with chronic pain to again, begin a new process of internal environmental change.
- Multidisciplinary Rehabilitation: Working with a team of healthcare professionals can help you manage your pain more effectively. This may include physical therapists, occupational therapists, and pain management specialists.
- Mind-Body Practices: Practices like meditation, yoga, and tai chi are clinically proven, effective strategies in managing chronic pain. These practices can help you relax and decrease stress, which can reduce pain.
Remember, there's no one-size-fits-all approach to managing chronic pain. What works for one person may not work for another. It's important to work with your healthcare team to develop a personalized plan for managing your pain. With the right tools and strategies, you can take back control of your life and start living pain-free.