Video and Transcript: The Causes of Nervous System Hypersensitivity

Hi everyone! Dr. Orit Hickman here from Pain Science Physical Therapy, and I just wanted to go ahead and do another video on pain, something that we specialize here at Lake Burien. And so, the next thing I wanted to talk about was, “What are the different things that lead to a nervous system becoming hypersensitive?” which is part of why chronic pain stays around. So, we're going to talk about different things that lead to nerve hypersensitivity.

The very first one is failed treatment. I want you to take a moment to maybe think about all the different medical practitioners that you have been to see about your pain. Maybe you've seen a physical therapist, an acupuncturist, a massage therapist, a chiropractor, a physiatrist (who’s a certain type of doctor that specializes in musculoskeletal medicine,) neurologist, your primary care doctor. Maybe you've even been to the ER a few times. And you may have seen multiples of each of these medical practitioners.

So, the more -- think about the first time you go in to see a medical practitioner, no matter who it is they are, about your pain. I would suspect that your main goal is for your pain to go away, at the very least for it to be better.

Well, does it really matter if you like the person that you're working with? If your goals are for your pain to be better, or for your pain to be gone, and that doesn't happen and every time you work with a medical practitioner your pain doesn't get better, that's failed treatment. So, that's a really big, important thing to take note of.

And, for some of my patients, I can tell you that they've told me that they've seen 20, 30+ medical practitioners over the course of time they've been dealing with their pain. So, it's not insignificant when you see somebody and your pain doesn't get better. This makes a difference. It amps your nervous system up a little bit more, gets more protective.

Along with failed treatment comes different explanations. So, every time you see a different medical practitioner, they give you a different reason why you have pain. And, often times, those answers don't actually lead to you feeling better. In fact, they can make you feel worse.

So, every time you see another person, and maybe their answer as to why you hurt is not the same as somebody else's answer, and those messages -- those pieces of information don't jive. They don't work well in your brain. In fact, they clash. So, seeing different medical practitioners, having different explanations, having lots of failed treatment, these are different things that contribute to a nervous system becoming more and more sensitive, more and more protective.

Job issues. Depending on the nature of your pain, this could probably impact your ability to do your job.

If your job is physical and you're not able to do certain things about your job -- with regard to your job, for example if you have back pain and you're not able to lift, bend, twist without pain, that, of course, is going to impact your job. But, then there are the other pieces of your job that maybe you don’t even realize have to do with your pain. And, that includes your ability to concentrate, and focus, and problem-solve. If you're dealing with chronic symptoms, it's going to impact your ability to do those things. So, that leads to problems on the job, which increases stressors, and, of course, increases hypersensitivity of the nervous system.

Fear and anxiety. When you experience a little bit of pain, there is a hormonal response to this and a Fight-Flight-Freeze response. This is something you don't control. This is the way that your nervous system responds to pain because, if you remember, pain is your alarm system propelling you to act.

So, of course, there's going to be a little bit of fear and anxiety associated with that. But, if your pain is really severe, then you might have more fear and anxiety associated with that experience of pain. And so that, of course, keeps your nervous system more amped up.

So, it isn't even just the fact that you're experiencing pain. There's also this other piece, which is the anticipation that you might experience pain. That also keeps your fear and anxiety up.

And, that can also lead to family/friend social issues.

So, your role within your household might change. Your ability to take care of your family might not be possible if you're a parent and you're experiencing pain. Even better, how you make choices about things that you're going to do with your life. You might choose to not take certain trips or vacations. You might choose to not go out and do certain social things.

A lot of the patients that I treat who deal with chronic symptoms are actually quite young and trying to be really, really active. And, they're not able to go out and do all the fun things that they were doing beforehand because of their pain.

So, this impacts your social life. It impacts how you feel, and you end up feeling very isolated. So, that keeps your nervous system in a really amped up state.

And, last but not least, just the fact that the pain has been continuing, so ongoing pain. The longer that you experience pain, the longer that you don't get a relief of your symptoms, despite multiple types of treatments. Maybe you’ve had surgeries. Maybe you've had injections. Maybe you've tried lots of different medications. The longer and longer that pain sticks around, the more sensitive and protective your nervous system gets.

So, here we have six different reasons why your nervous system can be hypersensitive and hyper-protective.

1. Failed treatments
2. Fear and anxiety
3. Different explanations
4. Job issue
5. Family or friend issues and
6. Ongoing pain

Let me know if this makes sense. If you feel like this was helpful, I would love comments down below. Definitely give me a thumbs up if you felt like this was a great video. And I'll see you guys next time. Have a great day! Bye.