The importance of pleasure in reducing pain

7 min. reading time

Els always loved to go cycling. Since the failed operation after her hernia, she has not been able to cycle. It hurts too much, getting on the bike is difficult and Els is afraid she will fall - and then hurt her back even more. She hasn't cycled for a number of years now.

If you are in pain for a long time, your brain gets better at 'creating' pain! That may sound a bit strange, but if you think about it, it's not so strange. Just think, you always get better at things if you do them for a longer period of time. When it comes to cycling, playing chess, running or arithmetic. The more you do something, the easier it gets for you.

In case of pain, that is rather annoying. It can cause you to feel pain much faster and more often under circumstances that are completely normal for others. That walking, cycling, gardening, or even a gust of wind can already hurt... 

importance of pleasure

The good news...

There is good news: this system can be undone. A proven effective way is to rebuild your daily activities very slowly and in doses. Take up activities that you enjoy, but no longer do, steadily again.

Why enjoyable activities? Well, first of all because it's the most fun... but if we look at our brains, it has two more advantages.

1. Your brain makes new connections faster if you have fun. And those new connections are important, because they will counteract the old 'pain connections'. Because you want to train your brain's hypersensitivity as quickly as possible, it helps enormously if you succeed in doing so in a way that gives you pleasure. It will also make it easier for you to keep going for longer.

2. It is more difficult for your brain to be in alarm mode when you are having fun. Your brain interprets all kinds of signals as 'danger' when you feel pain. In the case of chronic pain, this is often completely unjustified, because there is no danger at all and you still feel pain! Having fun from before your brain is difficult together with 'danger'. Real danger and pleasure just don't go well together. 

What is it like in your life?

So... when you look at your own life, are there activities that you avoid, but that would give you a lot of pleasure or used to do that? Is it possible to practise in small steps?

In the case of Els, she realised that she would love to cycle again. The step to ride a bike had become so big and scary that she decided not to do it at all. She was also disappointed in herself, because she used to cycle 50 kilometres and now she wouldn't be able to. In the end, Els and her physiotherapist practised getting on and off the bike. When she felt more secure, she slowly started to expand. She now cycles 5 kilometres a day, but that took two months! Still, Els can enjoy the kilometres she does.

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