A New Understanding of Pain That Can Help You Find Relief

Understanding Pain as a Warning Signal 0:00

Pain, a new view. I want to talk to you about how we think of pain and what is now happening that's new in the medical and psychological community as far as the new understanding of Pain. So it's important to know what pain is for. Pain is certainly a warning sign. It tells us that we may be in imminent danger. injuring our bodies, or like holding your hand over a hot flame, the pain tells you to move your hands out of there. So it's a very important message. And if you don't move you hand out in time, you'll sustain tissue damage.

You may have blisters, it may turn red, and be painful after the tissue damaged has happened. That is acute pain. What happens with acute pain, you feel it. You feel in what's called the periphery. Your brain is considered the center of things and anything out in your body, whether it's your hands, your feet, or your tongue with burning mouth syndrome is called peripheries. So messages get sent from the peripheral, from your burnt hand. up to your brain to a place in your where it registers that part of your body.

So there is an imprint on your for every part where you might feel something. Pain, touch, pinprick, all of that is registered in a certain place and it tells you that it's your right hand and its been damaged. And that's acute pain. And when we think of pain, that the kind of the pain we thing about. It's very direct. There is a known tissue damage and a register in your brain at that spot that tells you which extremity it is. Whether it's right or left, whether it your feet or your hand, Whether its high in you arm or actually in fingers, That all is registered in the brain.

So pain is a warning sign. It keeps us safe and it keeps alive because some pains warn us of something that's life threatening.

From Acute Pain to the New Definition of Chronic Pain 2:23

But there is new definition of pain and is the definition pain that applies more to chronic pain. And chronic ends up being a whole different animal than acute pain, and we'll talk about that. This is from the International Association for the Study of Pain, and this is their new definition. Pain is an unpleasant sensory and emotional experience associated with actual tissue damage, or potential tissue damage or described in terms of such damage. So if you burn your hand and it turns red and blistered, you know, there's actual tissue damaged.

But what if if continue after your hands heals and looks completely normal, the tissue damages healed, what you continue to feel pain or burning in that hand? So how does that happen? you get worried about it, you have fears about, and in fact the worries, the fears and the anxieties can amplify pain. So part of our pain circuits actually go through the emotional center of brain. In addition to being lodged where it tells you physically which part your body, there also is a more central emotional part in your brain where pain signals pass through.

So you don't necessarily even have to have tissue actual tissue damage potential or a description of that damage is enough to consider the feeling to be pain. And pain, like I said, is an emotional experience. It's, sensory number one, you're feeling something, but it's also an emotional experience and this is not to diminish people who are having chronic pain who unfortunately get written off as it is all in your head or you must be crazy or, You know, your just very anxious about something that's a normal experience.

I don't mean to write people off at all. What I'm going to tell you about pain is actually very empowering. and can help you get over pain. So the issue of actual tissue damage versus potential tissue damaged. There is a famous story in the pain literature about a construction worker who was using a mechanical nail gun, which you know drives nails into wood or whatever you're doing at very high speed. And he had an accident and drove the nail through his shoe, completely through the shoe. It went through from the top to the bottom.

And, he was screaming in agony as he got taken to an emergency room. When he went to that emergency, they removed his shoes and looked at what had happened. The nail in fact had not penetrated his foot at all. It had gone right between two toes and there was no tissue damage at.

How Pain Moves Into the Emotional Brain 5:47

All his interpretation of what happened, what his brain did was interpret this as a severe painful experience because his. Brain registered it as tissue. Damage, even though there. Was not any. Our brains can do that and. It may tie into how pain goes from being acute pain to chronic pain. And there's something called the chronification of pain. So how do we go from, you burned your hand. It was a stupid thing to do. You didn't realize it was so hot. you got a blister, the blisters broke open. it, was raw underneath, then it healed.

And now your palm looks completely normal, but you continue to feel burning pain as if you had just been burned. What happens when that goes on? pain starts living in a different place in your brain and functional MRIs, which are magnetic resonance imaging scans have been done in people who have had what's called subacute pain, back pain for about two months. It was a famous study and looking at where the pain resided in the brain on what is called a functional, MRI scan, see what areas of the brain are activated.

And it turns out that as pain becomes more chronic and long-term, and it usually means more than three months or six months, pain starts to live in a different part of your brain. It no longer is living in the place where it registered what happened. it is now registering in. The emotional part. Of your. Brain. So your brain has the ability to generate pain with little or no actual tissue damage out in the periphery. The good thing about this, if your pain can generate, pain, your, brain can unlearn to, generate that pain or learn to take that, away.

And there are, a number of interesting techniques. We get into them more in our Hope for Burning Mouth course. If you're in the membership community and in course, you find out more about specifics on how to get treated using your brain to overcome pain. So I would encourage all of you to join VMS Hope and the Membership Group where we talk about this on a monthly basis. There are some things that will contribute to the chronification of pain. And we're beginning to understand the effects of trauma, childhood experiences, not only in pain, but in our health overall.

Trauma, Childhood Stress, and Chronic Pain Risk 8:55

There's something called the ACEs scale or survey adverse childhood events or ACE. It's a list of 10 questions that asks about childhood. Did you grow up in a home where somebody was incarcerated? Did your growup in home were there was abuse going on? did you grew up at home, where there is drug use going and it's a list of 10 questions of things that are very impactful on children. And it turns out that out of these 10, if four or more and particularly if six or four are true, you have a greater incidence of many diseases from diabetes to cancer to mental disease and to pain.

So what happens in childhood is unfortunately can be a setup for things to happen throughout our lives and into adulthood. And it's actually very fascinating because some of these adverse childhood experiences physiologically change us. They result in more inflammatory chemicals being produced, which then inflammation is really at the root of all chronic disease. And with COVID, everybody's heard of cytokines, so which are inflammatory, chemicals that get ramped up during COVID. Well, those cytocines get wrapped up for other reasons at other times in life and adverse childhood experiences can ramp up those side of kinds and make us ill later in And it turns out you don't have to have a really classically, physically, or sexually abusive childhood.

If your parents were demanding and perfectionistic, if you got bullied in school, these are things that are traumatic enough to set you up for an increased risk of pain later in life. We're living through a pandemic, like I mentioned before, we actually got started. The stress of that pandemic puts us all at increased risk of painful experiences getting chronic, chronified or turned into chronic pain. the other things are socioeconomic situations, financial distress, living with adversity, Racial adversity, all of that, we are now understanding contributes to health problems and pain is one of them.

So what are the things that we can actually do about it? One is to reduce to the best we can, whether it's through therapy or other techniques that we describe in more detail in the course, the fear and emotional input into pain and often doing that will reduce pain. I had one patient when I explained the pain process and how pain, chronic pain goes through the emotional center of your brain and if you can reduce some

Reducing Fear and Reframing Pain 12:22

of your fear and anxiety, it can reduce your pain and he is a really lovely and very open and suggestible person and just hearing that enabled him to implement and find that his pain was somewhat reduced. Most of us are not as open, and we require more work to overcome our fears and anxieties. work either with a therapist or work on some deep emotional issues that can end up showing up as pain and that is another part of this whole new understanding of pain is the idea that pain may be due to emotional issues that we have repressed and not fully dealt with and I think that can play a role as well.

I'm also a bit leery about, especially with burning mouth patients, saying that there is no actual tissue damage and it's emotional issue that are playing into it. because there's a lot that we don't know about Burning Mouth Syndrome. We know a LOT more about chronic back pain and so that's been studied quite a bit and what's being found out is, yes, lots of people have bulging discs and, what are called osteophytes or bony spurs in their back and misalignments of their spine. And these have all pain has been attributed to all of these, but it turns out people have these but don't necessarily have pain.

And a lot of people who have had pain and thought it was due to these various physical changes in their spine have found out through the power of dealing with their emotions and being open about deep feelings, kind of letting go of what they're holding on to through their pain, have found relief of their pain. And so yes, there are bony spurs. Yes, they're a bulging disc. Most of the time they are probably not actually the cause of pain with burning mouth syndrome. The definition is that it's a burning pain for which no physical cause can be found.

Yeah. People go to dentists, your nose and throat doctors, neurologists. Everything looks okay inside their mouth and dentist as well. And it turns out that at least in some people with burning mouse syndrome, they're in fact under special staining, which is only done in research centers. So it's not commonly done. Biopsies of the tongue show degeneration of certain nerve fibers. And so, you know, is there tissue damage? Well, there probably is tissue damaged in people who have degenerated nerve fibres.

Some of pain may be due to actual tissue damage. Some of the pain may be due to amplification of pain through fear and emotions. And some of these kind of warnings or not warning signs but indications that your pain maybe pain that is amenable or subject to using your brain and emotions

Burning Mouth Syndrome and Emotional Factors 15:48

to overcome it. Some of the indications are if your pain started during a particularly stressful time in life. does your pain move around to different places? Because physiologically, if there is tissue damage, the pain should always be, your brain should be interpreting that pain is coming from that area of tissue damaged. So if it's sometimes on the right side, sometimes the left side. Sometimes upper body, sometime lower body. Those can be indications that there has been chronification of pain and change in pain from strictly acute to chronic pain, which now is more involved in the emotional centers of the brain.

And I've seen some nice examples of one of our patients with burning mouth. had a serious unresolved conflict with one of her siblings after the death of their mother. It really weighed on her. She didn't realize that that was playing into her pain. she read about some of the authors who talk about how suppressed emotions can translate into pain, had productive and open emotional talk with her sibling and her pain decreased incredibly. So that is an example of how our emotions get involved in our pain.

Again, I hesitate to say anything particularly to the Burning Mouth community about the emotional components of pain because people with burning mouth have been so written off, not believed, and not taken seriously, but I can tell you, I take you seriously. I know that you have a very significant problem. We work on it together, we work it through the course, through my website and the information that I have there. But acknowledging the emotional part of your pain, can really be liberating. So I encourage all of you to start thinking about that and join us for our Hope for BMS course.

We'll be posting how to join it and especially our membership group. we meet once a month for an hour the last Thursday of the month and we will be talking about topics in burning mouth syndrome and will actually be having a meeting two days from now this Thursday at 5 p.m. So if you join the course and join a membership group in addition, we look forward to seeing you there. Thank you so much for joining me today and I hope this has given you some interesting insights on pain.