PAIN and your BRAIN
- Pain by definition is an "unpleasant emotional response to adequate nociception and there is no correlation between the amount of pain one experiences and the level of tissue damage."
- Increase heart rate
- Increase blood pressure by increasing constriction of blood vessels
- Increase respiratory rate
- Increase sweating
- Indirectly increase muscle tone
The pain pathways then ascend in the spinal cord to the brainstem and limbic system (a primitive area of our brain dealing with emotions) and to the somatosensory cortex (the area of our brain which is a map of our body to allow us to localize sensations).
It is of great importance to note that approximately 75% of our pain pathways direct information to our brainstem centers and limbic centers. Only 25% of these pathways actually connect to the somatosensory cortex. The significance of this is that oftentimes one may have dysfunction of the tissues (subluxations, degenerative joint disease, etc) and activation of their nociceptors and pain pathways, which result in sympathetic changes in their nervous system, without the perception of pain.
Therefore, one cannot judge their health by the absence of pain or symptoms. Blocking
one’s pain perception with drugs does not mean that they are not experiencing the effects of nociception.
Long-term activation of nocicptors causes "wind-up" in the pain-sympatetic loops. Essentially "central sensitization" increases efficiency of the pathways by the growth of more nerve connections and the production of more neurotransmitters. This central
sensitization results in hypersensitivity, not only at the sight of injury, but in many tissues of the body. It is also responsible for the overactive stress response leading to many negative widespread subsequent changes in our bodies and may eventually lead to the patient’s developing chronic pain syndromes such as sympathetically mediated pain, complex regional pain syndrome, or reflex sympathetic dysfunction.
Patients with these pain syndromes and reflex sympathetic over activity have difficulty rehabilitating themselves because the reflex sympathetic dysfunction compromises the blood delivery to the muscle. Patients subsequently fatigue quickly, which causes the release of further pain-activating chemicals. As a result of such dysfunction, one is predisposed to overuse type syndromes.
The Chiropractic Neurologist's unique approach to effectively treat these syndromes is
two-fold:
By restoring the biomechanical integrity of joints and muscles, tissue healing following acute and chronic injuries improves. This will greatly decrease the amount of nociception. If addressed in the early stage following an injury, the probability of wind-up and central sensitization is decreased.
Improving biomechanical integrity of joints will also increase the firing of mechanoreceptors. This activates relay centers in the brain to inhibit pain pathways
along with inhibiting sympathetic functions. The Chiropractic adjustment is unique in its ability to activate these pathways without placing a further demand on the
sympathetic system. Exercise, which is commonly utilized in the rehabilitation of these syndromes, can be harmful in early stages because of the demand it places on the sympathetic system. It should only be utilized once appropriate sympathetic control is achieved.
Keri Barnes, DC DACNB, has extensive clinical experience dealing with early diagnosis, treatment, and rehabilitation of individuals suffering with a variety of pain syndromes.
To appreciate this statement, one must develop an understanding of how pain is processed by your brain. Imbedded throughout many tissues of the body - - especially the skin, joints, ligaments, tendons, and muscles-- we have free nerve endings acting as pain fibers that respond to harmful mechanical pressures and chemicals liberated from tissue damage. These free nerve endings are called nociceptors.
When nociceptors are activated, they transmit signals into the spinal cord where we respond reflexogenically by activating sympathetic nerves, which mediate our "fight or flight" response. The sympathetic nervous system has the following functions:
