Nowadays we have alarms going off all over the place. They are there to remind us, alert us, warn us and many times just annoy us. Not only are they all around us, they’re also inside us. Our bodies have their own alarm system in the form of pain.
Pain is your body’s way of bringing awareness to an area. Sometimes it’s urgent like a security alarm letting us know we need to stop what we’re doing and assess the situation. Other times it’s a nagging alarm reminding us that something isn’t quite right.
Just like a smoke alarm, louder (more painful) alarms do not necessarily mean more significant damage or threat. A smoke alarm is just as loud for a burnt piece of toast as it is for a kitchen fire. A paper cut can feel like a kitchen fire but it’s just burnt toast.
Problems could arise if your smoke alarm becomes more sensitive after you burn your toast. What if it started sounding off every time you use your toaster? Smoke alarms don’t tend to malfunction in this manner but our bodies’ alarm system often does. In cases of chronic pain your alarm system may start triggering with previously pain free movement or with movements of body parts uninvolved in the original injury.
Fortunately, there are ways to help decrease the sensitivity of your alarm system. Unfortunately, it’s not as simple as buying a new smoke alarm. Things like stress, fear, poor sleep, worry and poor nutrition can all increase the sensitivity of your alarm system.
Fear avoidance, the avoidance of movements or activities based on the fear of pain or re-injury can lead to a cycle of increased sensitivity and limited motion that can be particularly troublesome. Slowly and safely returning to movement, activity and exercise is the best way to lower the sensitivity of your alarm. Improving other factors such as nutrition, sleep and psychosocial wellness also go a long way to quiet it.
Sometimes, it’s enough to just know that the kitchen isn’t on fire. Smoke alarms become a lot less concerning when you know that everything is alright. It becomes a lot easier to control the situation and even ignore the alarm until it finally shuts off. Learning about pain and how your environment, fears, worries, stress and past experiences affect it can help you manage your alarm system better. Just like that smoke detector, our pain alarm system is an important tool to alert us of danger but they both need proper maintenance to work effectively.
Fear avoidance in pain free adults
I can’t even count the number of times I have been told or have told someone to lift with a neutral spine. ”Don’t bend and lift!” ”Keep that back in neutral!” Little did I know that I could be causing more harm than good. Keeping a neutral spine with heavy lifting or certain work environments may still be prudent but our preoccupation with limiting spinal flexion with everyday activities is leading to fear avoidance even in those without pain. Avoiding movements out of fear can lead to protective strategies that cause rigid motor behaviors which themselves can lead to pain in the long term.
What do you fear? Have you adopted some protective behaviors? Awareness is a key initial step in change. There are many tools out there to help us tune into those things that we may be avoiding due to fear and anxiety. One specific tool for chronic pain was developed by the NOI group. They utilize the concept of DIMs (danger in me) and SIMs (safety in me) to help you recognize those thoughts, feelings and experiences that may be increasing your pain/stress and those that help to decrease it. Check out examples of journaling your DIMs and SIMs and see if you can work toward tilting the scales in favor of your SIMs. Find more information about DIMs and SIMs at the NOI group webpage.
The more we fear certain movements, the less we move. Let’s focus a little less on how we “should” move and focus more on just moving.