The feeling of pain is not the same for everyone, and the ways in which it affects the body is not the same for everyone either. While science has long understood the neural pathways behind pain, we are just discovering why it affects people so differently. Pain can physically change your brain. The perception of pain, especially chronic pain, is affected by many factors: physical, psychological, social, contextual, and environmental to name a few. However, over extended periods of time and exposure to these different stimuli, our brains will physically adapt and change the neural pathways involved in pain perception and in movement. Basically, our brains re-program to fear the pain and avoid movement of the area that may potentially cause pain.
We can’t always change the physical pain, but the good news is that we can re-train how our brains experience pain! A study performed by Dr. Robert Edwards of Harvard School of Medicine recently proved this. Dr. Edwards performed MRIs on patients with chronic low back pain as they anticipated pain and performed physical movements that might be painful, and repeated the study adding a manipulation or adjustment while performing the same tasks. He found that after receiving therapy, patients reported lower pain scores, as well as lower anticipated pain. The MRIs showed reduced activity in the brain’s pain pathways, after therapy was performed.
This is powerful research in the world of chronic pain. The current most popular treatment for chronic pain is opioids, which are sometimes able to mask the symptom of pain, but are unable to target the actual cause of the pain. Non-pharmacological and manual therapy is much more effective in reducing actual pain, as well as retraining the brain to process that pain in a healthier and more functional way. This also explains the benefits of ongoing symptom management and reason maintenance care is so beneficial at preventing the onset of pain and guarded physical movement.
Ellingsen, DM et al. Brain mechanisms of anticipated painful movements and their modulation by manual therapy in chronic low back pain. J Pain. 2018 Nov;19(11):1352-1365.
Kettner, N W. “Retraining pain via the brain.” Chiropractic Economics, July 2019, pp. 26-30.