Rethinking Long Term Pain As Your Favourite Cocktail

Introducing The Pain Mojito

Pain can really suck.

Like a LOT.

Especially when it becomes more persistent and hard to get rid of (generally more than 3 months).

We often find ourselves searching through all different modalities that claim to be the cure to your pain. We try so many things, yet at the end of the day, pain still remains.

Part of the reason why finding results might seem like such a daunting task could be due to the way pain has been treated and conceptualized in the recent past. While we have had so much progression in the literature, so little ends up at the front end of healthcare. 

It is time we reconceptualize pain to enhance how we treat it.

In this blog, I plan to do that through the analogy of a delicious cocktail. 

Where we are going wrong on our pain treatment

Pain can be extremely complex in its nature. Once upon a time, we assumed that pain originated from a harmful stimulus, leading to a damage to tissue, leading to that tissue telling us it was sore until it healed. 

By this logic, we would be led to believe that if pain is there, tissue damage must be present. 

Not only this, but it leads us to believe that the source of our pain is within the ‘damaged’ tissue, and the tissue alone. 

But as we learn more and more, we find that this answer just seems too simple. The tissue is NOT the only thing that influences pain.

We now know that pain has a number of influences, with what is happening at the tissue level being only one of those influences.

When you go to make your favourite cocktail (lets say, a Mojito), you must have all the ingredients (lime, sugar, rum, soda water). If it were missing the rum, it would not be a mojito. If it were missing the soda water, it would be a strange sweet rum lime drink of some kind, but still, not a Mojito. You need all the ingredients of the Mojito all the time or it is not a Mojito.

And in our pain analogy, changes in the tissue (note, not DAMAGE to the tissue, but changes) is the soda water. An important piece of the puzzle, but not the full cocktail. We need the other ingredients for it to become pain.

For pain to happen, we need all the ingredients, all the time. 

While this makes pain seem complex, it also means that we treat so many more ingredients to your pain cocktail, some of which are a heck of a lot more influential to your pain than the tissue itself. 

Furthermore, focussing only on the tissue and trying to change it could be doing a disservice to your pain and recovery.

So what are the other ingredients to the pain mojito?

Treating the soda water (or the changes at the tissue) is only treating one part of the pain problem. So what else is at play here?

A key concept to remember is that pain is NOT an output of the tissue, and is ALWAYS decided by the brain (🤯 right? Sounds crazy but stick with me).

Treatment that tries to change the tissue for chronic pain management are the ones you will see the most – massage, posture changes, dry needling, desk set up, stretching, taping, massage, theraguns… you name it, there are millions!

While these may feel great in the short term, they only treat such a tiny piece of the puzzle, and (arguably), very ineffective pieces of the puzzle. 

Things that we know play more of a role than the tissue itself on levels of ongoing pain include:

  • Fear of a poor prognosis
  • Sleep deprivation
  • Stress and anxiety
  • Depression
  • Fear of moving
  • Overcomplication of the structure and source of your pain (if someone has taken a scan of your injury and tried to explain it to you in exquisite detail/in a way that sounds scary)

While this might seem strange, the above factors are the other ingredients to your sweet pain Mojito outside of our tissuey soda water. All the above factors can influence, or ‘prime’ the brain to decide if there is pain present or not (remember, stick with me, pain is an output of the brain).

So again, most times we go to treat pain, we get a small and ineffective slice of the pain pie given to us to try and improve the pain through ‘aligning’ your body, ‘switching on’ certain muscles or ‘releasing’ so called ‘tight’ tissue. 

You could call these low quality tools in the persistent pain toolbox.

Let’s start with our high quality tools instead.

Where to from here?

Great, you now know that trying to roll out your tight muscles or aligning your body in a perfect seated posture at all times might not be doing a whole lot for your overall pain recovery. Thanks Alex, very helpful 🤦‍♀️

While these still have a small effect, there are so many more higher quality tools in our toolbox we can address.

There is hope and much more effective strategies we can work on to help manage that ongoing pain that the above treatments only seem to touch the sides of. There are still so many ingredients to our Mojito aside from our soda water. 

If you are someone who lives with chronic pain, and wants to find a way to improve it, here are some quick first steps you can take to help address all elements of your pain Mojito:

  • Find a practitioner that makes you feel safe and communicates with you well
  • Where possible, avoid practitioners that leave you feeling scared, broken, or with more problems than you went in with. They may be doing more harm than good.
  • Have a look at your sleep, and if there is anything you can do to improve it. It might just take a small amount of thought and effort to tidy up your sleep hygiene
  • Stressed, anxious or depressed in general life? Consider if this might be taking a toll on your pain, and if there is anything that can be done to help it.
  • Remain confident in your body – it can (and will) heal. Movement is not dangerous if you can find the right level for you (which may take some guidance ✋)
  • After discussion with a healthcare practitioner you trust, consider the need for imaging and if it is necessary. (read a bit more about this here)
  • If any of these steps feel overwhelming (which they often will), seek the help of someone who understands pain well (Exercise physiologist, physiotherapists, osteopaths (etc) who specialise in chronic pain). A great healthcare team is perfect for your guidance to make this journey seem as simple as possible. 

There you have it. Pain as a (not-so) sweet Mojito in the sunset. 

Lets focus on our high quality tools in the toolkit, and look at all parts of the pain pie for an effective result. 

And of course, if you need help, reach out. We are only a phone call (or an online booking below) away!

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