Why Do I Still Have Pain After Healing?
Why Do I Still Have Pain After Healing?
Pain that persists even after an injury has healed is often a result of how your nervous system responds to pain and injury, not just the physical damage itself.
Here’s a neurological breakdown of why this happens:
1. The Nervous System’s Role in Pain:
When you get injured, pain signals are sent from the affected area to your brain via nerves.
This is your body’s way of telling you something is wrong, so that you can protect it.
Normally, once the injury heals, those signals should stop, and the pain goes away.
However, in some cases, your nervous system continues to send pain signals even after the injury has physically healed.
This is called chronic pain and is related to how the brain and nerves handle pain information.
2. Pain as a "Memory" in the Brain:
Pain isn't just a physical sensation; it’s also processed in the brain.
After an injury, your brain can form a kind of "memory" of the pain.
Over time, even though the tissues have healed, the brain still "remembers" the pain.
This happens because the nervous system can become sensitised—it becomes more efficient at sending pain signals, even in the absence of ongoing tissue damage.
This is known as central sensitisation.
It’s like your brain and nerves are on high alert, overreacting to normal stimuli (like movement or touch) and continuing to signal pain even though there’s no longer a reason for it.
We often use the analogy of your body being the kitchen, and your nervous system being the fire alarm.
Imagine the kettle caught on fire (the initial physical injury). Thankfully your fire alarm goes off (experience of pain). You rush to the kitchen and put out the fire, and replace the kettle (natural healing of your injury).
But the problem is, after this incident the fire alarm has become very sensitive (sensitisation).
Now even with a brand new kettle, the steam that comes out is enough to set the alarm off again (Normal stimuli causing pain)
3. Nerve Pathways and "Short Circuits":
Another way of understanding chronic pain is to think of the nervous system like a series of electrical circuits.
When you get hurt, a pain circuit is activated. If that circuit gets used over and over, it can get stuck in the “on” position, even after the injury heals. This leads to overactive nerve pathways, where the nerves keep sending pain signals unnecessarily.
Sometimes, even a light touch or normal movement can trigger these overactive circuits, causing pain that doesn’t match the level of injury.
4. Proprioception and Miscommunication:
Your body has sensors called proprioceptors that provide feedback to your brain about where your body is in space, how it’s moving, and if something hurts.
Think of these proprioceptors like instrument players in an orchestra. Each has a different role; each plays a different sound. The conductor (your brain) is responsible for controlling and listening to these players.
When you’ve been injured (broken instrument), these sensors can get "confused" or misfire (play the wrong tune), sending incorrect information to the brain (conductor) that something is still wrong, leading to persistent pain.
Even though the injury is healed (replace broken instrument), these proprioceptors (players) might not have "reset" correctly, continuing to send faulty signals of pain.
5. Inflammatory Chemicals and Nerve Sensitivity:
During an injury, your body releases chemicals (like prostaglandins) that cause inflammation and increase the sensitivity of your nerves to help you heal.
However, in chronic pain conditions, these chemicals can linger longer than necessary or cause the nerves to remain hypersensitive.
This heightened sensitivity means that your nerves can respond to even minor stimuli with pain signals, even though the tissue is healed.
Lifestyle habits also play a big role in this. Poor sleep, diet, and habits such as smoking increase the production of these chemicals
6. Emotional and Psychological Factors:
Pain is influenced by emotions, stress, and anxiety.
If you’ve been in pain for a long time, your brain can become more anxious or stressed about it, which amplifies your perception of the pain, increasing its intensity.
The brain areas involved in emotional responses (like the amygdala) can intensify pain signals, making it harder to break the cycle of pain, even when your body has physically recovered.
Think of the sensitivity in your body like a little flame on a match stick.
Emotion is the petrol, increasing the intensity of the fire.
7. Muscle Memory and Movement Patterns:
After an injury, you may start moving differently to avoid pain, creating new, less efficient movement patterns.
Over time, these compensations can cause new areas of discomfort or strain.
The muscles and joints might not return to their original, efficient way of moving, leading to continued discomfort even after the injury heals.
In Summary:
After an injury, even though the tissues may have healed, your nervous system can stay "stuck" in pain mode due to overactive nerve pathways, sensitised pain circuits, faulty proprioceptive signals, and emotional factors. This can result in chronic pain that persists well beyond the actual healing process.
Understanding this helps explain why pain can continue even when there's no visible damage and highlights why treatment needs to address not just the physical injury but also the emotions and nervous system's response to it. Techniques like P-DTR, manual therapy, and mindfulness-based approaches aim to reset these overactive pain signals and restore normal function.
