Chronic Pain and the Brain

 In Blog Post

(Scroll down for solutions to chronic pain)

We hear the same story over and over.

“I haven’t been the same since… XYZ”

“I just woke up with pain.”

“I went to the MD, Neurologist, PT, (enter specialist here), and they told me they can’t do anything more for me, even though I still have pain.”

The ONE thing these practitioners have in common, is that they are NOT addressing the brain based model for pain.

You see, pain signals are being sent at all times by pain signaling nerves called nociceptors. These nociceptors are inhibited in the spinal cord by proprioceptors which send signals from the body including, muscles, joints and skin. (This is one of the reasons why we shake our hand when be “jam” our fingers- this is proprioception taking place to inhibit pain) Also this is why chiropractic and exercise works so well for pain control.

Now the brain based component to pain control involves the cortex and the brainstem. The brainstem houses areas responsible

for descending pain inhibition; the periaquaductal grey (PAG) in the upper brainstem, Rostralventromedial medulla (RVM) in the lower brainstem, and locus ceruleus located in the middle all have different effects on pain, ie different mechanisms.

The more important component of chronic pain involves “flaring up” these areas, or dampening their output. Inflammation, stress, and poor brain-gut axis function are 3 main ways chronic pain continues to exist, because it makes certain areas over-fire, and other areas under-fire.

What can be done for chronic pain? I’ve tried all medications, I’ve tried PT and nothing has helped.

Let’s consider the brain-based approach to pain modulation.

First, we need to evaluate to see if the pain signals coming from a certain area (low back, shoulder, neck, or even knees) is due to localized pain or centralized pain.

Centralized pain means the pain signals in the brain and spinal cord have become extremely efficient at transmitting this pain signal, and they have become “plastic”. Plastic in neurology means that something is very efficient at sending a signal. Pain can become plastic (bad), happiness can become plastic (good!), depression can become plastic (bad)… you get the point.

 

Now let’s get back to chronic pain. There’s a few different types or pain

  • Localized pain– this is acute pain typically due to an injury or tissue destruction- all other pain is central or neuropathic
  • Centralized pain– the brain and spinal cord have become very efficient at perceiving pain, even after the local tissue heals
  • Neuropathic Pain– this is an abnormality in the pain-signaling neurons themselves. Example knee pain- patient gets surgery on knee and still has pain=neuropathic or central- we perform our Neuro-Orthopedic Rehabilitation and pain decreases= this was neuropathic pain

 

What to do for chronic centralized pain:

  • Eat foods that are not inflammatory in nature– high sugars, gluten and dairy products, corn, soy, lectins, and grains can all be inflammatory in nature. Try removing some or most of these and see how your pain levels change
  • Get your mind right– perform simple home exercises that can change the way your brain works to help calm you down (if stressed), to think more positively (if depressed or unhappy), start a gratitude journal.
    • We recommend a 4-4-8 breathing patterns then visualize happy and positive thoughts. Breathe in for 4 seconds, hold for 4 seconds, and breathe out for 8 seconds. Pursing your lips on the exhale seems to work best.
  • Address underlying triggers or pathology– often times this is external stressors, poor work or home relationships, not dealing with a past emotional trauma as well as the above mentioned triggers in food.
    • Address gastrointestinal issues leading to chronic inflammation– if you experience any type of gastrointestinal issue (diarrhea, constipation, pain, bloating, vomiting etc)  you will likely be at risk of developing chronic pain due to the chronic inflammation. Bacteria, Yeast overgrowth and Parasites in the gut are the most common things found in our patients and removing these appears to yield some of the most dramatic results in conjunction with our Neuro Orthopedic Therapies and Brain Based Therapies
  • Perform Brain Based Therapies and Exercise– Once we determine which areas of the brain aren’t working we use different therapies to activate those areas. Activation comes in the form of electrical stimulation, vestibular stimulation, cognitive therapies combined with breathing and eye movements- whatever is found in your neurological exam is addressed.
    • At ACNC, we use vertical and horizontal eye movements to optimize center of pressure (balance and sway patterns) so that muscle relax that are over firing. This approach tends to help balance the system more effectively leading to longer lasting results than just typical adjusting, soft tissue, and PT techniques.
  • Functional Neuro Orthopedic Rehabilitation– We use this specifically for localized chronic pain- it seems to work best with pain in the low back, shoulders, neck, knees, and feet. We use  a patented neurogenic pain cream that we work into specific nerves that are dysfunctional. This goes right on the skin, is odorless and produces great results.
  • FDA Approved Low Level Laser Therapy– Low Level Laser Therapy or Cold Laser Therapy is an amazing tool to use with pain and brain. Our patients often ask “can I just get laser done?” when there aren’t any full time slot appointments available. It works through cellular mechanisms and decreases inflammation, improves blood flow, increases BDNF (a nerve growth factor), and modulates the immune system. If you have a GI infection, we use a different laser with a violet colored beam compared to the red laser we use for pain and fat loss.

 

If you have chronic pain and are finally looking to get rid of it, or significantly improving your quality of life, give our office a call and we will get you and your brain evaluated and begin to employ all of our therapies to give you the best chance to live a happier and more pain-free life.

 

Call us at 480-756-2600

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