PNE: a framework to help you with understanding your Chronic Pain and strategies for relief
It can be challenging not knowing what is going on with your body when you have been experiencing chronic pain, and even more frustrating when traditional methods of treatment provide no relief – but, with Pain Neuroscience Education, you can improve your symptoms by just learning about your pain.
Pain itself is a natural part of the everyday human experience. Infact, 25.3 million adults in the United Stated (US) are suffering from daily chronic pain, including adolescents and children. Pain Neuroscience Education (PNE) aims to bridge the gap between the physiological aspects of pain and each individual's pain experience in order to create an effective treatment strategy to help start reducing pain.
PNE promotes the understanding of chronic pain and aims to reframe maladaptive thoughts around pain, such as pain-catastrophizing.
A Guide to your Pain:
This article's goal is to be a quickly accessible tool for you to gain information on PNE and have some beginning treatment strategies we use at RTC to help patients with persistent chronic pain.
Part #1: Education on your Pain
Part #2: PNE based Interventions
Part #1 PNE: Education on your Pain
PNE is an education-based model used primarily by Physical Therapists with the primary goal of educating patients with chronic pain about where pain actually comes from. The very first step of this process is allowing for the education to occur. Typically, your physical therapist may ask you if they can share some information on pain models and analogies that may help you with your understanding of your pain experience.
For example, your physical therapist may describe pain as your bodies "alarm system" meaning that when the brain perceives damage or the threat of damage, our body then creates a movement response in order to protect us from potentially hurting ourselves. This manifestation, or the "alarm" before our movement response, is our feelings of pain. In real life, you may have pulled your foot away from something sharp as to not hurt yourself, and that is your bodies alarm system allowing you to move before more damage could be done.
Chronic pain is often when the alarm system in our body becomes heightened and persists even when there is no active damage being done to our body. It's important to note that while pain is a signal that comes from the brain, your pain "isn't all in your head."
Why is that? A big take away from this education is that pain is not a damage indicator, but merely gives us an idea of where we are experiencing pain.
This education is just one example of how PTs educate on persistent pain. There is a myriad of examples of our pain system and how it works. A great resource used in clinical practice is a video called "Tame the Beast" where the beast is the representation for pain.
Part #2: PNE based Interventions
Now that we have discussed pain and where it comes from, we can now discuss things that you can do to help start improving your pain.
A great place to start when it comes to intervening with PNE, is to write down questions about your pain. Reasearch has shown that when patients know more about the physiological side of pain, the faster pain goes down and potentially goes away.
Going along with the alarm system example from above, the following are some questions you can begin to ask yourself. Write your answers down, and when you see your Physical Therapist or a provider you trust, they can help you answer these questions:
What is the purpose of an alarm?
Do alarms tell us why the alarm was activated?
Would a fire alarm tell us how bad the fire is? Do you need fire for the alarm to go off?
Can you think of times where you had no pain but definitely had damage?
Do you wonder why you need to know this?
Answering these questions is a great place to start in terms of gathering information about your view of pain and the analogies that may have been explained to you. It also gives you the opportunity to be in control of your chronic pain journey and make positive changes towards your outlook on pain.
Progressive Muscle Relaxation
PNE should be used in conjunction with movement in order to get the maximum benefit. It's important to have a balance between feeling empowered to do your daily activities, while also not overdoing it as to not overextend yourself and cause a flareup.
One example that you can do to both prepare for or wind down from activity/flare ups is progressive muscle relaxation (PMR). Progressive muscle relaxation is an activity that often will be done with your Physical Therapist first, and then can become self-guided. The general outline is doing gradual tightening of the muscles in a top-down or bottom-up fashion, moving from region to region and entering a relaxed and mediative space after each contraction. The goal of PMR is to start introducing movement into the muscles without increasing pain.
Another great resource is by following along the
"Therapist Aid" YouTube video. You can choose to do these activities seated or laying down, whichever is more comfortable.
PNE is an effective intervention when used in Physical Therapy for those with persistent chronic pain. There is evidence to show that using some of strategies outlined here has improved patient self-efficacy, tolerance to daily activity and most importantly, improving pain. Our therapists at RTC use this treatment approach and have found great success with our patients.
If you are in pain or know someone who would benefit from our approach, call 757-578-2958 or visit www.restorativetherapyco.com today! Thank you for reading and feel free to share.
Contributed by Frances Rogers, PT, DPT
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