The source: Three Sources of Chronic Pain

• Possible structural problem
• Inflammation of soft tissues
• Neurophysiological Disorder – “short circuits”

The receptor—your brain

Three additional variables affect your perception of pain:

• Sensitization
• Memorization
• The “Modifiers” –1) anxiety 2) anger 3) sleep

Chronic pain is a complex problem and even more so, as each person is unique. It won’t respond to isolated simplistic treatments. The approach that is successful in solving pain is similar to that of fighting a forest fire.

“I Can Only Fix What I Can See”

These concepts apply to pain in any part of the body regardless of the source. I will discuss low back pain as one example. The exact source of your LBP is usually unclear.  Many assume if you are pursuing a diagnosis with your doctor then there must be an indentifiable problem that is solvable with surgery. Surgery is felt to be the “definitive” solution.

• It is only definitive if you can see the problem.
• Even then the potential benefits must outweigh the risks.
• I often compare spine surgery to dentistry. (Back Pain vs. Mouth Pain)

A high percent of spine surgery should never be performed.

• What many surgeons are defining as “structural” is simply normal aging anatomy.
• Degenerative disc disease is not a disease.
• All intervertebral discs lose water content with age.
• They have been shown not to be the source of your chronic LBP.
• A fusion for a degenerated disc has a success rate of < 30%.

Video: “Get it Right the First Time”

Surgical Results Overly Optimistic

Marsha’s Three Needless Spine Surgeries

The post Understand Chronic Pain first appeared on Back in Control.

The post Understand Chronic Pain appeared first on Back in Control.

I am extremely committed to not missing an anatomical problem. It is not good for anyone. Most of the time, increasing pain isn’t related to a structural problem. In these cases, the pain gets worse because of the way the brain processes any repetitive stimulus. Your brain learns your pain the way you learned about U.S. history when you were in high school. Most of us learned our homework through repetition, and much of the knowledge gained becomes part of who we are. It becomes ingrained in the brain.

When your brain is hammered week after week, month after month, and sometimes year after year with the same pain impulses, it becomes very efficient in processing them. It takes less of an impulse from your back to elicit the same response in the brain. The same impulse causes more neurons in the brain to fire. It is this process that causes patients to complain that their pain is getting much worse in spite of no additional trauma.

Listen to a discussion in a video: Your Brain Becomes Sensitized.

Clear Research Data

The phenomenon was clearly documented in a clinical study done in 2004. Volunteers who had no experience with chronic pain had a light pressure applied to a finger. The researchers measured the response in the brain with an MRI that is able to track metabolic activity. It is called a “functional MRI.” They consistently identified one small area of the brain that responded to this pressure. The same pressure stimulus was then applied to patients who were experiencing chronic pain. There were two chronic pain groups: one consisted of people with chronic LBP of more than three months; the other consisted of people who suffered from fibromyalgia. In both groups, five areas of the brain lit up. Although the fibromyalgia group experienced more diffuse body pain, anxiety, and depression than the CLBP group, the fMRI scan data was almost identical. This carefully done study documents clearly how the brain becomes sensitized to repetitive impulses.

Water Torture

Water torture provides a crude example of how the brain gets sensitized. A poor prisoner is strapped to a board and water is dripped onto his or her forehead. It is only a drop of water. The intensity of the “source” of the sensation is mild and does not change over a period of time. With the repetition, the nervous system becomes focused on it, and the sensation becomes intolerable. The victim usually goes insane.

There are two situations where pain may increase: 1) either more pain receptors are directly stimulated, which in turn stimulates more neurons in the brain; 2) the central nervous system becomes more sensitive and the same stimulus now recruits more neurons to fire.

Remember, the final pain you experience relates only to the number of neurons firing in your brain.

See a related story: Pain Sensitization – A Frayed Wire.

The post 2 – Sensitization to Pain first appeared on Back in Control.

The post 2 – Sensitization to Pain appeared first on Back in Control.