Nociceptors throughout the body detect painful stimuli and send signals to the spinal cord and brain. The brain can then send signals to the body to respond appropriately. This process works well for pain that can be reduced by removing the painful stimulus. However, some pain cannot be relieved by removing the stimulus and can last longer, regulated by the body's internal mechanisms. People with chronic low back pain have a lower tolerance for pressure applied to painful areas compared to those without chronic pain. They also have hypersensitivity to touch in areas away from the primary injury site. Chronic pain patients have a decreased ability to internally regulate this type of pain through a process called conditioned pain modulation, where a painful stimulus at a remote site can

1. How doespainwork?
We have specializednervescallednociceptorsthroughoutourbodythatdetectpain.Where the signal is
interpretedaspain,bypainful stimuli whenthesenervesare activated,theysendasignal tothe spinal
cord, thenupto the brain. fitness centre The braincan thensenda signal outto the body foran
appropriate response.Thisprocessworkswellforpainthatcan be reducedbysimplytakingawaythe
painful stimuli.Some paincan’tbe relievedbyremovingthe painful stimuli.Thistype of painfeltfora
longerduration,butalsothe body’sowninternal mechanisms.
What aboutchronic pain?
Whencomparedto a control group of people withchroniclow backpaincan have the lowertolerance
to pressure appliedtopainfulareas.Inareasawayfrom the primaryarea of injury,thishypersensitivity
to touch wasalsonoted.To internallyregulate thistype of painBecause of aperson’sdecreasedability;
theydon’tbuildatolerance toit but actuallybecome more sensitive.Patientswithchronicpainand
theirdecreasedinternalresponse toit,bya process,calledconditionedpainmodulation(CPM).With
CPM, painful stimuli canbe usedat a remote site todecrease painat the primarysite. Forpatientswith
chronicpain,thisCPMresponse isreduced.Physical Therapycanemployvariousmanual therapy
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