The SCHC IPPC Physical and Occupational Therapy Series on Understanding and Treating Chronic Pain

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May 10, 2022

By Diana Kinslikh-Mohamed MSc OT Reg. (Ont)

Occupational Therapist, Interprofessional Primary Care Team

The most common reason for referral to Physical and Occupational therapy at SCHC’s IPPC team is chronic pain.

Every day we work with people who have been suffering from chronic pain conditions anywhere from 6 months to 30 years and more. The experience of pain has many factors including social circumstances, emotional wellbeing, and physical ability. The good news is that there are things you can do to treat your own pain.

The first and most important step is to understand what exactly chronic pain is. There are currently two main ways of understanding chronic pain and they both involve understanding a little bit about how your brain and nervous system work.

1. The body is able to heal many injuries either on its own or with some therapy/medical intervention.  Often times muscles, bones, and tendons will heal within months.  However, some people will continue to experience pain even though their injury had healed a long time ago.  Why does this happen?  The brain gets used to the fact that you have an injury and becomes fearful that you will injure that area again.  It therefore continues to send pain signals in an effort to warn you and protect you.  In addition, the brain may have also associated certain activities, times of day, and maybe even specific situations with pain and therefore continues to send those pain signals even though none of them are actually harmful to your body.
2. The second way of understanding chronic pain is as a “Diagnosis” developed by the late Dr. John Sarno who named this diagnosis Tension Myoneural syndrome or TMS. He wrote four books on this topic describing all the conditions that fall under this diagnosis from back pain to fibromyalgia, and even irritable bowel syndrome. Dr. Sarno stated that our brains sometimes protect us from fully experiencing certain uncomfortable emotions such as anger or fear.  However, these emotions don’t just disappear, they linger in our unconscious mind until they are somehow triggered and end up expressing themselves as physical pain.  The emotions show up as physical pain because the brain appears to prefer this as a kinder experience for us than emotional agony.  The brain creates these pain signals by restricting blood flow to various parts of your body, often times to areas of old injuries.  This can affect absolutely any kind of tissue including muscles and nerves and can show up as anything from a muscle ache to shooting electric kinds of pains.

​Fully understanding the concepts above and how they relate to the individual experiencing pain is important to treatment. For this reason, we will be releasing weekly content to make you more familiar with chronic pain and steps you can take to overcome its effects on your life.

Your first step is to test your knowledge about chronic pain. Please complete this quiz by answering true or false for each question.