The body has always been the main target of our efforts to treat pain. We touch it, rub it, put things into it, manipulate it, stick needles into it, exercise it, cut things out of it and replace parts of it. Throughout history we have looked at, felt, listened to, smelled and even tasted the body or its byproducts to help us figure out what is causing pain.

No matter the kind of medicine, Western, Eastern, Naturopathic or alternative, the body has usually been the focus of attention. This makes sense of course. Unless we are talking about emotional pain, we feel pain in the body. In fact, the whole point of being able to feel pain is that it tells us there is something wrong with the body that we need to deal with.

Historically, most treatments for pain were directed at the part of the body where pain is felt. It is obvious that we would pay most attention to the part that hurts. However, this is changing as we come to understand pain better. Central to this change has been increasing knowledge of how the brain and nervous system work. As I’ve repeatedly emphasized in these posts, the experience of pain is the result of complex neurological processes that include such things as sensation, emotion and learning. Acute pain usually signals injury, either from disease or trauma to a particular body part. In chronic pain there is often no evidence of continuing injury even though that is how it feels to the affected individual.

Chronic pain often persists despite temporarily effective treatments directed at the part that hurts. This may be because the brain systems and nerves involved in the production of pain also require treatment. If for example, you have chronic neck pain following whiplash, a soft tissue injury may have triggered changes in the nervous system that continue to cause pain after the original injuries have healed. Treatment directed at the neck alone (e.g. neck manipulation, physiotherapy, surgery) would therefore be unlikely to eradicate such pain completely. This is in fact what happens in treatment to the majority of chronic whiplash patients.

None of the above suggests that we ignore the part of the body that we feel pain in simply because the pain has become chronic. It illustrates that in chronic pain our senses may not be able to identify all the sources of our pain. Treating the rest of the body, not just the affected part, may provide better relief in managing chronic pain by altering physiological mechanisms involved in producing pain. In particular, treating the brain and nervous system may result in controlling neurological mechanisms that create the experience of pain wherever you may happen to feel it.

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