NCTV Episode 25

Continuing with the series of bitesize health tip videos which can be found here on my YouTube Channel, this episode, includes:-

  • A break down of what it is
  • How it develops
  • How to regain control
  • The Biopsychosocial Model
  • The 5 influencers of pain perception


If you’d prefer to read the content within, rather than watch the video, then feel free to read the transcript, as follows:-

Hello and welcome to NCTV Episode 25 on the topic of Understanding Chronic Pain

So the first thing you need to understand about chronic pain is that it changes lives, impacts self-image, affects others and interrupts plans

The NHS defines it as persistent pain that carries on for longer than 12 weeks despite medication or treatment.

It’s a disease that sometimes the person living with doesn’t understand and others don’t always accept especially for example, when someone is bedridden one day but un-impaired the next, which can obviously be difficult to explain to others.

It can hinder you from activities you enjoy and reduce the ability to take part in routine tasks so it’s normal to feel angry about it, however, understanding and acceptance can take you from the ‘why me’ to ‘what now,’ which is a powerful step towards gaining control of your body and your life again.

So to break this down, firstly, pain is there to warn you that something is wrong (for example an infection or illness), or to protect you from injury.

However, unlike acute pain, which lasts temporarily, chronic pain is persistent and the pain signals can continue for weeks, months or even years even though there may be no evidence of any residual tissue injury or illness and yet the pain continues to send signals to and from the body and brain.

Chronic pain can also develop slowly, sometimes for no obvious reason and it may also even come on several months or years after an activity or injury like a car accident or surgery

It can be felt in either a specific part or throughout the whole body. The pain may be continuous or vary in its intensity

Sometimes it can flare up or get worse very quickly, while at other times it is easier to manage. It can also have other symptoms like numbness, burning or piercing.

Chronic pain traditionally has been hard to manage as there is no specific muscle or tissue damaged, and it often doesn’t respond to ‘normal’ treatments, hence the frustration it causes for its sufferers.

It’s like the body’s nervous system being on red alert. The nerves become so sensitive that they send pain messages for even the slightest touch or movement, or in some cases for no reason at all.

The biopsychosocial model of pain explains how no two people or their pain are alike. Each individual’s chronic pain is made up of a combination of their bio, psycho and social situations, bio (biological – being from the body), psycho (psychological – from their mind, emotions & feelings) and social (being the environment in which they live or have lived). All of these components will influence your pain and how you are able to cope with it. Whether there is an injury or tissue damage or in this case chronic pain, a pain signal is sent out in your body and what happens next depends on you and the following 5 things:

1) Your thoughts and how the pain signal is perceived. For example, general body aches and stiffness may be seen as “good pain” when these occur after exercise, whereas they may be “bad pain” when related to a medical condition, like rheumatoid arthritis or fibromyalgia. In a person having had an experience of past trauma, be it abuse or an accident, possibly an injury whilst on military duty; any time they experience pain it can elicit thoughts of the past pain and experience, which can make the current pain worse. Even though the pain may be completely different and unrelated.

2) Emotions. The emotional aspect of pain is a person’s response to their thoughts about the pain. If you believe the pain is a serious threat (eg. a tumour), then emotional responses will include fear, depression, and anxiety, and possibly panic among others. However, if you believe the pain is not a threat, then the emotional response will be negligible. Your emotional state at the time the pain develops may also influence its outcome. People experiencing severe stress at the time of developing chronic pain, often battle to manage that pain due to the ‘attachment’ it has with a certain time in their life. Dealing with the emotional issue will be as important as managing the pain in order to recover.

3) Suffering. The word “suffering” is often interchanged with “pain” even though they can be two very different things. For instance, a broken bone may cause pain without suffering (since the person knows the pain is not deadly and the bone will heal). In contrast, bone pain due to a tumour may cause the same pain as a break, but the suffering will be much greater due to the “meaning” behind the pain (this tumour could be life-threatening). Therefore, the degree to which a person suffers is often very closely tied to their emotional connection with the pain.

4) Pain behaviours. Pain behaviour is your physical reaction to pain – what you do. These are behaviours that others observe as typically indicating pain, such as talking about the pain, grimacing, limping, moving slowly, and taking medicine. How you physically react to pain can be affected by previous life experiences, expectations, and cultural influences in terms of how the pain is expressed. Interestingly, pain behaviours are also affected by the outside environment, such as how others respond to you. How much sympathy and help you have around you may influence how much or how little you do on the bad days.

5) Outside environment. Your environment, including your home, where you work and play/socialise will also influence your response to pain and how you act or cope with your pain. You may not have a choice but to go to work for fear of losing your job and being unable to support your family. If you don’t collect the children from school, who will? Friends encouraging you to join them for the rugby and a beer at the pub may seem like a challenge, but getting out and having a laugh is also good for your emotional wellbeing and a balance in life.

Your experience of pain always stays with you, there is a kind of memory for it. If you experience pain every time you carry out an activity or task, then it is unlikely that you will continue with it, and you develop a ‘no go’ list of activities. Thinking of the pain before it happens can make it feel worse. If you are anxious or tense about doing something, hormones in your body can affect your perception, often making you more sensitive to pain. Likewise if you enjoy doing something then hormones called endorphins (a feel-good chemical) can be released and make the experience more enjoyable and possibly less painful.

So there you have this week’s bitesize bit to help your health flourish, hopefully that’s increased your understanding and awareness of chronic pain now and as you can tell by this being the longest NCTV to date, there’s a lot to it, so be sure to look out for a future episode which will provide the necessary guidance and skills on how to cope with Chronic Pain.

Bye bye for now.