Not one thing, but many

When something hurts, we usually have a belief as to what caused it.  Often, this intuition is wrong.  For example, we might blame a sore knee on a rugby injury from 25 years ago that hasn’t been a problem in the interim, or it’s our office chair, or some strange idea about carrying a bag on one shoulder.  Usually just one thing.  It’s called a post hoc reasoning fallacy (post hoc ergo propter hoc, if you want to sound flash), which roughly translates to:

·       I saw a thing happen

·       Then another thing happened

·       Therefore, the first thing caused the second thing

We also fall for the fallacy of a single cause – the first thing AND NOTHING ELSE caused the second thing. Even when we understand this we are still doomed to repeat this mistake; logical fallacies are powerful.  That said, if you hit your foot with a shovel and it hurts for a week, maybe not much of a mystery.

You go to the gym everything’s going well and now your leg starts to hurt. Obvious possibilities might include a muscle strain or perhaps you’ve overdone it or not had enough recovery time.  However, what if you haven’t overdone it and you have allowed recovery time? Let us cast the net a bit wider.

Consider these things that pop up in life:

·       A few bad night’s sleep in a row

·       A rotten cold or flu virus

·       Menstruation

·       A big stressful life event or ongoing stress

·       Poor diet

·       Depression

·       Anxiety

If you think about a time when you may have experienced any, or all of these, they certainly interact and compound each other, don’t they?  Neurobiological research shows that all of these contribute to heightened sensitivity to pain – things hurt more.  Things that hurt a long time ago, might start to hurt again because the nervous system has a way of remembering these things.

Scenario.  You always have a stressful meeting on Thursdays.  Wednesdays you don’t sleep so well because of the impending awfulness.  Thursday evening, you finish the bottle of wine as a reward instead of saving it, which wrecks your sleep making you tired, irritable and fed up on Friday, which is now take-away and more wine night.  Saturday morning, you hit the gym and your bloody neck pain from 5 years ago is back!  You shuffle home feeling sorry for yourself and wonder what went wrong in your neck.

Stress is a big one, you cannot overstate the impact it has on your body.  When we experience ongoing stress we’re in a flight/fight/fright mode.  Our heart-rate and blood pressure elevate, our digestion and immune regenerating slows our bodies are on high alert and cognitive tasks and rational decision-making becomes more difficult.  We might feel this as a physical tension and it’s more difficult to move in our usual, natural and relaxed way.  Maybe this isn’t the time to set a new personal best in the gym or try to run that extra mile.

“Are you saying stress causes leg pain?”

No.  It, along with many other factors, contributes.

The idea that thoughts and beliefs, or mental wellbeing affect pain can seem far-fetched. But…

Y’ver notice?

·       The smell of chips makes you hungry even when you’ve eaten.

·       The thought of a bully you had makes your stomach ache.

·       Indigestion makes you feel stressed.

·       Opening a jar of pickled onions makes your mouth water.

·       Imagining an argument makes your heart-rate increase.

·       Your joints ache with the flu (are they injured?)

·       You bump your head with a hangover, and it kills (are you more damaged?)

·       Your toothache eases when you arrive at the dentist.

Just the tip of the thinky-feely-brainy-hormoney iceberg.

What can you do?

The more you look for these patterns, the more tuned into them you become, and the better you can take care of yourself and let yourself off a little.  If you sense that it’s been a really tough week and you’re feeling run-down, try taking it down a notch, have a lighter session to feel good.  Exercise is almost always far more beneficial for mental health than just about anything else you can do, so do it.  But recognise the times to ease off – it’s not going anywhere without you, so be kind, recover.  Take time to identify the factors that might be contributing and one by one, see if you can make some small changes.

Pain is never a simple A causes B event.  It is the result of a weird and complex interaction between your nervous system, neuroimmune and neuroendocrine mechanisms, beliefs, experiences, genetics, social context, and of course, your amazing, beautiful and silly brain.

But trust me, on the shovel.

Take care,

Tris