Understanding Pain, written by Exercise Physiologist Sarah Abbott.

Pain serves a vital purpose, signalling danger and prompting action to protect ourselves. However, our body’s protective mechanisms can sometimes become overly sensitive, leading to the unpleasant experience of persisting pain. By challenging assumptions about our bodies, through movement and sense-making, we can respond differently to these warning signs and begin to influence our pain experience. Movement helps to reinforce in a very embodied way that it is okay to move and we are safe in doing so, while sense-making helps to reframe what is going on, lessening the protective mechanisms at play.

The Body Budget

Coined by Lisa Feldman Barrett, the Body Budget concept suggests that the brain’s most important job is to regulate all the systems of the body, like the respiratory, cardiovascular, immune, endocrine and nervous systems, by allocating resources to them efficiently. Energy efficiency is compared to a financial budget, but instead of tracking money earned and spent, the body budget tracks resources like water, oxygen, glucose, hormones, and salt. Actions that replenish resources, like healthy habits and social connections, are deposits, while activities that deplete resources, like social conflict and sleep deprivation are withdrawals.

Movement and learning cost us the most resources, but while they are big withdrawals to the body budget, they can also be considered investments. Your future self will get a really good return on these investments, when investing wisely, through its ability to more efficiently regulate all the systems of the body, including aspects of pain processing.

Six Effective Ways to Influence Our Pain Experience:

  1. Moving Well: Exercise is foundational for maintaining a healthy balanced body. The use of movement to treat pain can seem counterintuitive as feeling pain changes how we move, but movement can also change how we feel. Exercise has shown to be sleep enhancing, anti-inflammatory, neuro-protective, analgesic, physiologically regulating and disease-risk reducing, and the benefits of exercise are exerted across the lifespan and exclude no one.
  2. Sense-making: Making sense of our painful experience can be overwhelming and information that is unclear, literally costs more bodily resources to attempt to understand. Learning helpful information, on the other hand, is an investment that may serve you well in the future and shift how you respond to pain in a very positive way. However, in order to make an investment like thinking differently, we need to have enough resources, and these resources need to be replenished.
  3. Sleeping Well: Quality sleep is essential for replenishing our body budget. The link between sleep and pain is tightly coupled. Some practical strategies to sleeping well include exposing ourselves to a regular light–dark cycle to reinforce our circadian rhythm (body clock), setting up a sleep inducing environment, monitoring caffeine, nicotine and alcohol, establishing a sleep routine, and integrating exercise into the day, as it’s sleep-enhancing.
  4. Eating Well: This can be tricky when highly processed food is so affordable, palatable and read–to-eat. However, large calorie consumption, especially from ultra-processed food is highly inflammatory, leading to an increased potential for pain. Skipping meals will also deplete your body budget. We need adequate energy intake to support exercise and daily movement, otherwise this becomes a double withdrawal from your body budget.
  5. Stress Management: Long-term stress is a big withdrawal on the body budget. There’s great value in getting a professional involved to help you manage your specific stress, and there is a smorgasbord of strategies that can be utilised; thinking strategies, relaxation techniques, mindfulness and meditation, prioritising activities that bring you joy, and prioritising adequate movement as exercise helps to re-regulate the stress response by turning the system on/off on a regular basis.
  6. Social Engagement: Building connections and engaging in meaningful interactions has the potential to be a big body budgeting deposit. The way we relate with others in the world impacts all dimensions of our wellbeing, including our body budgeting abilities. Staying curious and exploring new possibilities (with/without professional help) allows us to learn where our needs might be met and affords us an opportunity to become unstuck and reconnected to the things we enjoy. Similarly, incorporating ‘play’ into our day, provides an opportunity for new and positive experiences to emerge in a very embodied way. Play gives rise to glee, happiness, joy, and it’s impossible for fear and playfulness to coexist! This may help to reintegrate a painful area back into the whole body system.

Circle of Concern vs. Circle of Control

While there are many things that concern us, pull on our attention and spend our valuable resources, we might have little influence over them. Focusing on aspects within our circle of control—such as achieving adequate movement, sleeping well, eating well, stress management, and social engagement—allows us to positively influence our pain experience. These six key areas also come up over and over again in the literature as effective ways to manage pain.

In Summary

Pain is complex, but this complexity invites us to consider more.

Consider how well you are presently moving, eating, sleeping, making sense, managing stress, and engaging socially. Each of these aspects will influence the balance of our body budget and with that, how vulnerable or resilient we stand to the experience of persisting pain.

Written by Exercise Physiologist, Sarah Abbott.

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