Have you ever noticed that when you are in pain you want to swear more? Researchers have looked into this and found that swearing may actually have an analgesic effect. They speculate that the brain circuitry linked to emotions might be involved; they found that when we swear we activate an ancient and primitive part of the brain, the ‘amygdala’ (an almond-shaped group of neurons that can trigger a fight-or-flight response in which our heart rate climbs, making us less sensitive to pain). Normal speech doesn’t trigger any activity in this area but thoughts, memories and emotions may do.
There are a lot of different definitions of pain, most of which involve a fairly in-depth understanding of neuroscience so I’ll spare you too much detail. Basically, pain is part of our brain’s way of ensuring that our bodies don’t do something damaging. Pain is a very sensible approach for your brain to take: e.g. if you have just fallen on an outstretched hand and broken your wrist, pain will stop you from causing any further damage to that wrist and give it a chance to heal. In fact, pain is essential to our survival as a species as it causes us to stop and pay attention to an injury and take action to help ourselves get better.
Unfortunately, pain is not so helpful when your injury is 15 weeks old and finished healing weeks ago. When there is no longer an injury or any danger in moving that wrist. This sort of pain is often referred to as chronic pain (chronic just means that it has been there for longer than the normal healing process should usually take – most people heal from even a broken bone within 8 weeks). Chronic pain is often the result of unhelpful beliefs or poor understanding about injury and healing or fear of re-injury. Where chronic pain is concerned, knowledge is power!
What is surprising to a lot of people is the fact that there is no ‘pain centre’ in the brain; no single point that lights up on an FMRI machine when someone experiences pain. There are no pain pathways either – instead, sensory neurons spend their time “sniffing” their environment and then reporting their findings back to the brain. How the brain determines your response to the information given to it by its neurons depends on many factors – it draws from the current environment as well as from you past experience, knowledge and beliefs.
Let’s take an example to try to help illustrate this – when you think of someone you love, perhaps a Granma, this thought will trigger activity throughout your brain: memories and emotions. You think about her smell (did she smoke? Maybe she wore Diorella?), and the part of your brain related to smell lights up; you think of the sight of her friendly face, and the vision part of the brain lights up; the feel of her scratchy nylon bedspread; the taste of her apple pie, and those parts also light up. The emotional parts of your brain are also lighting up with feelings of love or loss or both. You see, there is no specific ‘Granma’ part of the brain.
Pain is very like this; if you happened to have your head in an FMRI machine and I came along and pinched your bum, your brain would light up all over like a Christmas tree – anger, irritation, fear or even amusement may feature as strongly as the unpleasant pinching sensation you experience in your bottom (and the fact that it is dark in an FMRI machine and that all you can smell is hospital). Each different painful experience has its own particular feature of brain points that light up. These little brain lights associated with pain are called a ‘neuro tags'. The good news is that if we can map a neuro tag we can set about changing it, hopefully for the better.
As a chiropractor, it’s my job to work out why you have your pain and what this pain means to you, taking into account your past experience, beliefs and knowledge – “Uncle Ralph had back pain then he was diagnosed with kidney cancer and died”, “my neighbour had sciatica for 20 years and it put her in a wheelchair”, “Dr Google says I have probably got a brain tumour!”. Or perhaps you only have positive knowledge of injuries? – “my dad had a bad episode of back pain but he went and got help and was back at work within a day or two”, “my GP explained exactly why, following taking a good case history and doing a thorough examination, he thought it was really unlikely that I have done anything serious or long lasting to my neck so I’m happy to wait for my body to do its own healing magic and I’m confident I’ll be pain free in a week or so”. Once I understand your perspective, we can come up with a plan of management that works for you.
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