Winning and Losing in the Pain Game
We often think of pain as a sensation with a cause and effect. B amount of tissue damage = C amount of pain and so on. But nothing could be further from the truth; in fact, there is so so much more to it than that.
What is pain modulation?
We could spend days discussing in depth physiology and psychology but that would get a bit too much for this platform so we’ll break it down a bit into some “sensible” language so we can appreciate the concept and put it to work in our own lives without needing a medical degree. Think of your nervous system as a highway, the brain at the master control site, the spinal cord as the freeway, and all of the nerves as main roads with each branching to hundreds of smaller and smaller streets heading to each tissue and gland in the body. Some roads are one-way taking information from the brain to the body or vice versa and others are two-way streets. Imagine on the freeway (the spinal cord), there is traffic. White cars carrying information to or from the brain and red cars - the pain cars carrying messages from the “injured” site to the brain. Pain modulation means, there are factors that can control how many red cars actually make it up to the final destination in the brain - the area that ultimately says ouch! Annnd then once in the brain, there are even more factors that can tell us if we should “worry” about this pain or brush it aside and carry on.
Our understanding of how people experience pain differently is expanding with every day that goes by and more and more recognition is being placed on the importance of addressing a variety of factors that “modulate” or modify pain. Because our brain’s perception of pain is impacted by so many different factors, sometimes considering and addressing these factors can be just as important as “fixing” the damaged tissue itself. As we navigate our healing path together, we’ll discuss various aspects of this concept of pain modulation and various approaches we can try to see if something sticks and becomes a game changer in healing for you.
Today, as the title suggests, we’ll look at winning and losing and how that can impact our perception and experience of pain. Then it’s up to you to leverage your mind in a way that’s more helpful for you, rather than have it act as a saboteur, cranking up the pain volume. You may have heard about the “psychology” of winning (the importance of mindset, visualization, positive drive, pushing our limits etc), but what about the “physiology” of winning? Are there actually physiological changes that happen when we win that can impact the way our body functions? The old saying that it hurts more when you lose - well, that’s a real thing believe it or not! It actually does! We see evidence of it watching professional and olympic sports all the time. It’s amazing what injured athletes can push through when the championship is on the line compared to a game that “doesn’t matter” or when all hope has been lost in a blow-out. Perhaps if you played sports as a child - or still participate now - you can appreciate that it seemed like injuries suffered when you won were outweighed by the excitement or anticipation of winning, but those when you lost just stung a little bit more.
Each time our pain message arrives at an intersection along the highway, there’s an opportunity for the message to stop, be modified (increased or decreased), or proceed as is. Body messenger molecules (i.e. neurotransmitters, neuropeptides, or hormones) can increase or decrease the signals our nerves are carrying when they get to an intersection. When we are “winning” or in the heat of close competition, we have higher levels of certain hormones like adrenaline that allow us to “ignore” some of the pain cars. Our highway becomes so busy going from the brain to the body that it’s hard for the pain cars to make it though the traffic jams. When we are really happy and excited because of our triumphant victory, more messengers, (like dopamine, glutamate, GABA, serotonin etc) are released into the mix, making it harder for pain messages to get through, and decreasing the impact of the messages when they do arrive. Although research is mixed on which ones play the most important role in their ability to modulate pain we know they play some role. For example, the ability of dopamine (a happy hormone) to modulate pain, is thought to be more involved in chronic pain scenarios. Acupuncture is often used for pain relief with one of the mechanisms being that it is believed to modulate many neurotransmitters - and therefore - change our perception of pain.
Endorphins! We’ve heard of those and generally know they feel good when our body releases them - but what are they? Well, those little molecules are our own home-made morphine. As you know, morphine and other opiates are sometimes prescribed when we’re in a lot of pain, but we actually have our own supply that we can tap into as well - and those come with fewer side effects! Endorphins are released by the body in response to pain, stress, exercise, sex, some manual therapies, even certain smells, foods and many other activities. They make us feel good and because of where they bind in our brain, they also act as natural pain relievers. So during high intensity activity, we’ve got these pumping through our systems. Add the excitement of winning and more continue to be released! Feel down and sad because you lost? Bye bye, endorphins and other “happy” neurotransmitters and hormones, it’s just you and your pain cars now :(
Of course there are other things we can do to modify our pain - even when we lose, but keep in mind, how important your “winning” mindset is in life, how beneficial it is for your pain to do activities you love, and hang out with people who make you happy too! Oh, and in the unlikely event that you do lose that championship game…make sure you find some ways to get your “happy” hormones back up - I hear that ice-cream with friends might just also help that ankle sprain feel a little bit better ;)