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Structural vs Non-Structural Pain Review
Pain is an essential part of our lives, serving as a protective mechanism that alerts us to potential harm or injury. Typically, when we experience pain, we attribute it to a specific structural problem such as a broken bone, a sprained muscle, or an inflamed joint. This would be structural pain. However, there is another type of pain that can be just as debilitating but does not arise from any discernible structural damage. This phenomenon is known as non-structural pain, and its roots lie deep within the complexities of the nervous system. When non-structural pain becomes chronic, the experience can be deeply confusing and isolating. Understanding non-structural pain and how it relates to the nervous system is the first step towards healing for many with chronic non-structural pain.
Read the in-depth breakdown of Structural vs Non-Structural Pain here.
Understanding Pain: Beyond Structural Damage
Pain affects us on levels beyond our physical senses, which is why it is referred to as a biopsychosocial condition (biological, psychological, and social). While structural damage can often explain acute pain, chronic or persistent pain that lasts beyond the expected healing time may not have a clear structural cause. Non-structural pain refers to pain that persists without a recognizable anatomical injury or underlying pathology.
The Nervous System and Pain Perception
To comprehend non-structural pain, we must first delve into the intricate workings of the nervous system.
The nervous system comprises the central nervous system (CNS), consisting of the brain and spinal cord, and the peripheral nervous system (PNS), which encompasses the nerves that extend throughout the body. The PNS includes the autonomic nervous system (ANS), which has two branches- the sympathetic and parasympathetic nervous systems. These are commonly known as the “fight or flight” mode and “rest and digest” mode, respectively.
When we experience an injury, specialized receptors in our skin, muscles, and organs send signals via the ANS to the CNS, where they are processed and interpreted as pain. This process involves a complex interplay of various neurotransmitters, neural pathways, and higher brain centers. In the case of non-structural pain, the nervous system may become hypersensitive, amplifying pain signals or misinterpreting non-painful stimuli as painful.
You can think about it like this:
Imagine your house was broken into (oh no!). After this happens, you install a security system to make sure the threat doesn’t come into your house again. However, this security system is so sensitive that it alerts you of everything- even small things a squirrel rustling by or leaves blowing in the wind. Your nervous system can get stuck in this “fight or flight” mode, alerting you to non-threatening situations as if they are major threats.
Contributing Factors to Non-Structural Pain
- Central Sensitization: The phenomenon of central sensitization plays a significant role in non-structural pain. It occurs when the neurons in the CNS become more responsive to pain signals, leading to an exaggerated pain response (think back to our analogy of the house with the security system that is on way too high alert). This heightened sensitivity can be caused by factors such as prolonged exposure to pain, emotional stress, or neurochemical imbalances.
- Psychological and Emotional Factors: Psychological and emotional factors, such as anxiety, depression, and past trauma, can influence the perception of pain. These factors interact with the nervous system, triggering changes in pain processing and amplifying the experience of pain.
- Neuroplasticity: The nervous system is remarkably adaptable and capable of rewiring itself in response to experiences and environmental factors. In the case of chronic pain, long-term changes in the structure and function of the nervous system can occur, perpetuating the pain even in the absence of ongoing tissue damage. This is the reason for the phrase “neurons that fire together, wire together”. While this neuroplasticity can be a great thing, because we always have the opportunity to make new “wirings” in our brain, this same ability can be used by our body to perpetuate chronic pain flare-ups.
Treating Non-Structural Pain
Addressing non-structural pain requires a comprehensive approach that takes into account the interconnected nature of the nervous system, emotions, and cognition.
Here are some therapeutic strategies that can be effective in managing non-structural pain:
- Multidisciplinary Pain Management: Pain can often be a complex condition, and finding the best solution can involve multiple resources and support systems. Seeking professional support is integral to learning more about your own unique pain journey and healing.
A multidisciplinary team should consist of healthcare professionals such as- physicians- psychologists- physical therapists- occupational therapists who can work collaboratively to develop an individualized treatment plan. Platforms like Flowly integrate with healthcare professionals, allowing users to benefit from both professional support and at-your-fingertips resources.
- Mind-Body Interventions: Because the mind and nervous system play such a large role non-structural chronic pain, learning how to soothe your nervous system is key. Techniques like breathwork and biofeedback. Platforms like Flowly combine these into an actionable and accessible resource to manage and soothe non-structural chronic pain.
Other mind-body strategies include mindfulness meditation, yoga, and tai chi, which have shown promise in managing chronic pain. These practices promote relaxation, reduce stress, and encourage a sense of well-being, thus positively influencing the pain experience.
- Cognitive-Behavioral Therapy (CBT): CBT aims to change negative thoughts, behaviors, and emotional responses associated with pain. By modifying beliefs about pain and developing healthy coping strategies, CBT can help individuals better manage their non-structural pain.
In VR experiences like in Flowly’s there is psychological education in the voice over of each session, which in some modules include CBT , ACT and more.
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Non-structural pain is a complex yet pervasive condition that affects many individuals. By recognizing the intricate interplay between the nervous system, psychological factors, and pain perception, we can begin to develop effective strategies for managing and treating this type of pain. Through a comprehensive approach that combines medical interventions, psychological support, and mind-body techniques, we can help individuals regain control over their lives and find relief from the burdens of non-structural pain.
Head back to Part 1, Non-Structural Pain versus Structural Pain: Understanding the Difference, here.