A huge question. With many answers. Deep breath… and go
Introducing a Non-Pain Stimulus
When you hit your elbow on something, your first response? To rub it. It just seems to hurt less.
A theory, called the gate control theory, explains this phenomenon. By rubbing a painful area, we introduce a non-pain stimulus which interrupts pain signals trying to reach the brain.
Receptors in the skin, joints and muscles are constantly sending signals to our brain via our nerves. The signals tell the brain the position of our joints in space, the length of our muscles, the sensation of our bottom sitting on a chair. Signals are also sent to the brain when our tissues are in danger. This can be hot or cold temperatures, excessive pressure or chemical irritation.
When we hit our elbow on the corner of a table a barrage of signals are sent to the brain – “Help! We’ve been damaged! Do something to protect us!”
To drown out this barrage of ‘pain’ signals, we can introduce non-threatening stimuli. Examples include cold (from an ice pack), heat, touch (rubbing your elbow), moving the joint (shaking your arm). Any of these stimuli interfere with the signals headed to the brain, and we feel better.
Manual therapy works in the same way. We touch the skin in a non-threatening way, and this works to modulate pain.
Reassurance and Education
Being in the hands of a professional. The practitioner may have seen hundreds of patients present the same way, but for a patient this is new and scary and they don’t know why they are in so much pain. A concise explanation of what is happening, and what is likely to happen over the next few days and weeks, can make a significant impact to pain.
Often soreness in the neck or back stems from one joint or muscle, with a response from the other tissues in the area. The protective spasm through the region can leave you feeling that you are incapable of movement. However, as a manual therapist treats the non-affected joints, and moves your body around, it demonstrates that you are able to move more than you realise.
Humans have an ingrained need for touch and care. As infants we are constantly cuddled and soothed. As children we fall over and run to our parents for a hug. Through adolescence and adulthood we form relationships for a sense of human connection and companionship.
The act of touching someone, in a therapeutic scenario, can be paralleled to soothing an infant or child. Gentle touch, rocking and rhythmic motions introduced during a treatment can remind our nervous system of being cared for as a child. This can reduce your sense of fear and anxiety, and reduce the level of pain.
Manual therapy clinics tend to be set up in a similar way.. dim lighting, soft music, a neutral colour scheme, and an uncluttered space. The area is designed to be calm and soothing. It is an oasis away from the stressors of everyday life, an opportunity to focus on nothing else but your own body.
So often people will walk in for a treatment and say “I feel like I’m wasting your time being here. When I made the appointment I was in so much pain, but I’m feeling much better”
The decision to do something has an effect on our experience of pain. You have decided to make an appointment, get this investigated, seek treatment. You have taken control of the situation. This has a huge impact on our perception of pain.