Maggie McKay (Host): When you find yourself in pain, all you want is relief. But how do we know what the right medicine and dosage is? Here to tell us more about the science of pain and how to manage pain, is Physical Therapist at Stoughton Health, Amy Brown. Welcome to Stoughton Health Talk, a podcast from Stoughton Health.

I'm Maggie McKay. Welcome, Amy. Thank you so much for joining us.

Amy Brown, PT: Thank you for having me.

Host: Pain is such a universal experience, and at some point in our life, we're all going to go through it, but maybe not know how to deal with it. So why is it important to learn about the science of pain?

Amy Brown, PT: Well, everybody has pain, and pain is normal and it's necessary. If we didn't have pain, we would die. For instance, if you imagine you put your hand in a fire and you didn't feel pain, you wouldn't have a response to tell you to pull away from it. So it's important that we learn to understand pain so it's not so scary for us. If we don't understand pain, it can start to consume our entire life and alter our physical and emotional responses.

Host: How has the study of pain science and education changed over time?

Amy Brown, PT: Well, early models in pain science go back many centuries and we thought there was like a pain nerve that was connected right to our brain. In the past, we used more of a biomedical model that focused on tissue and tissue injury. But it doesn't really explain all the pain and it was incomplete. Well, often people will heal, but they still have pain. So then we started doing more research in the last 20 years on pain science and have really advanced our knowledge of this. And we're learning more that we don't really have pain nerves, but we have fibers called nocioceptive fibers that give a message to our brain. And then our brain is what interprets it as a pain response. And so we're doing quality studies now to understand that response and how we can affect our pain response.

Host: Thank goodness, right? Giving us some relief. Amy, why do some people have painful experiences and get better while others have similar injuries and have pain that lingers?

Amy Brown, PT: There are a lot of reasons, but one is our own personal experiences with pain. If you've been educated in pain and understand pain, it won't be as threatening to you and you'll recover better. For instance, physical therapists often work with pain and have the same number of episodes of back pain as other people. Because we understand the pain, we rarely miss any work, and we recover much quicker because we understand what's going on. But if we have multiple negative events in our life, that can affect our recovery and affect how well we heal and how we feel about it. But other factors can also influence our recovery.

And some of those would be like fear or depression, anxiety, poor nutritional habits, poor sleep habits, reduced activity, the use of other medications or alcohol. If you have punitive or overprotective family members, they can influence how you heal. Working night shifts make it harder to heal because we don't have good sleep habits. Uh, if you don't like your job very well, you don't heal as well. Or if you don't like your boss or your coworkers, that makes it harder to heal too. So.

Host: That's a lot of factors.

Amy Brown, PT: It is.

Host: I never really considered that all those outside things had to do with healing. When it comes to pain education, does it work?

Amy Brown, PT: Yeah, there's been multiple high quality studies done recently that show that pain education actually reduces pain and improves our function. They've done some studies where they compare the use of pain education combined with exercise and stuff, as well as comparing it to use of certain medications like our gabapentins or antidepressants that are commonly used for pain. And they found that you need a lot less people to treat to make a difference that with pain education than you do even with those medications.

Host: And what can I do to help reduce my pain?

Amy Brown, PT: The first thing is to educate yourself on pain and how it works. Otherwise starting to exercise has been really shown to help, especially aerobic exercise. The key, though, when you start an exercise program is to start slowly and progress gradually. The most common problem people have with exercise is they start way too aggressively, and then they'll have a rebound effect with their pain. And that actually is teaching your brain that the exercise and movement is bad, and will make your pain worse. So instead, we have to start progressing just to the point where we are getting close to our pain threshold, but not too aggressive and then slowly increasing that level so we don't get that rebound effect of pain. But there's other things we can do including just making sure we get good sleep hygiene. Sleep is the time when our body is, can heal. And so if you're not getting the sleep, then you're not going to heal as well. So a regular bedtime is helpful and other good sleep habits. Also just setting goals for yourself that are realistic and then being willing to modify them if you need to, that can be helpful too.

Host: So where do we learn more, about pain management?

Amy Brown, PT: Yeah, there's a lot of really great podcasts out there on the science of pain. There's several TED talks that are out there, but if you even just search podcast on pain science, you'll find a lot of them that will pop up and there's some really great ones there. Also there's a lot of really great resources on understanding sleep and how that can help you.

One of my favorite speakers on that, his name is Matthew Walker, and he's a PhD scientist that studies sleep. He's very entertaining in his education too. But we'll also be hosting a free one hour Zoom presentation called The Science of Pain on October 26th from 5:30 to 6:30. So if that's something you'd be interested in learning more, you can go on stoughtonhealth.com and then click on classes and events. Otherwise you can also call our number at 608-877-3498 for more information on that zoom class.

Host: That's great. Thank you so much for this informative conversation. It was really helpful. Is there anything else you'd like to add before we wrap it up?

Amy Brown, PT: No, but thank you for having me.

Host: Absolutely. That's Physical Therapist, Amy Brown. And if you'd like to find out more, please visit stoughtonhealth.com. If you found this podcast helpful, please share it on your social channels. And for more topics of interest to you, check out our entire podcast library. I'm Maggie McKay. This is Stoughton Health Talk, presented by Stoughton Health. Thanks for listening.