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The Role of the Brain in relation to Pain

Pain perception

The Complex Homunculus

homonculus1

 

Brain Map

There is a representation or map of every body part in the brain. Consider this the ‘virtual representation’. The correct term for this representation is a homunculus. These virtual bodies inform us of what our ‘actual’ bodies are doing in space.

Above are 2 homonculi, 1 representing the skin and the other representing movement. In the sensory homunculus, you will notice the areas in the brain devoted to the lips, hands and face are larger. This indicates that areas which require better sensation have a larger representation. The same is said for the motor homunculus as areas which you use more have a bigger representation. Again this is adaptable depending on your line of work, hobbies etc. For example an author will have a bigger representation of their dominant hand due to writing with the hand a lot.

Chartered Physiotherapy

Smudging & the Homunculus

Smudging

Imaging studies reveal that chronic pain results in changes in the virtual representation of the area affected. ‘Smudging’ of the virtual limb so that there no longer is a clear defined outline of the body part is one such change. This can result in an overlapping of neighbouring body parts. I like to compare this to driving in fog. When driving in fog, your vision is compromised. You are no longer sure of what is ahead on the road.You slow down, turn down the music, you may even roll down the window. You become very cautious and hyper-vigilant in an attempt to control the environment.  The brain is similar when unsure of what exactly is happening in an area. It can become very conservative in its management at times causing the neighbouring areas to hurt or areas that didn’t hurt before can start to hurt.

The more chronic the pain is, as in the longer you have been experiencing the pain, then the more advanced changes in the brain have occurred. For example the more difficult that body part will be to use or the more sensitivity you will have in that body part or the neighbouring areas. Ultimately, the physical body mirrors the state of the virtual representation in the brain.

Educated Movement

The great news is that smudging is reversible. Educated movement is excellent in helping to normalise the virtual representations in the brain. Every time you move in a pain-free controlled manner it is positively reinforcing normalisation of smudged representations. Furthermore, it is the understanding why pain occurs and removing the threat of the pain which enables you to move freely. This reason alone is why so much emphasis is placed upon the biology of pain. It is a huge help to understand the science behind this marvellous process. By gifting ourselves with this knowledge, we are allowing ourselves to increase our physical capacity, reduce pain and improve quality of life.

‘Explain Pain’ by Lorimer Moseley and David Butler is a brilliant book which has formed the basis of these blogs. It is written with the aim to enable individuals who experience chronic pain. I would highly recommend it.

Should you require any further information on this topic of pain please do not hesitate to contact me in Personal Health on 01 4964002.

pain, chronic pain, exercise, physio, physiotherapy

Do you really understand your pain? by Dee Ryan, Chartered Physiotherapist

Pain is often misunderstood, and as a result can cause fear. This fear and confusion can drive our pain experience. This blog explores the true meaning of pain with you. It might facilitate a different approach to your pain management, and hopefully can improve your coping strategies.

Pain is the body’s alarm system. It is designed to be a helpful response to protect you. This alarm system is assisted by your vision, hearing, smell and taste. For example, at halloween you see a bonfire, hear the wood crackling, smell/taste the smoke and feel the warmth. These sensory cues are helping your brain decide how best to respond to a given situation.

FireBeachPain
A key point to understand about pain is that once the brain decides you’re in danger, you will feel pain with or without the presence of tissue damage.

YOUR BRAIN DRIVES YOUR PAIN

Pain can be straight forward. But like most things in life, it can also be a complex process requiring some patience. Pain from direct tissue damage is clearly understood – an ankle sprain for example, see our Rory McIlroy blog:

Here, for example, the ligaments are sprained and in an attempt to protect you (how loving!) your brain decides the ligaments are at risk and need healing. Subsequently pain is felt in order to allow ligament repair and remodelling.
Pain can also be reflective of behaviour, emotions, memories, belief systems and what the pain means to you. A nice analogy for this is to imagine the ingredients of emotion, stress, memory, belief and behaviour are mixed together and make up the batter to a special kind of cake called pain. This cake is cooked in a particular oven called the brain. How the cake of pain turns out is very much so dependent on the oven – what temperature it is cooked at, how long it is cooked for etc. So it is clear the brain directly influences the end product- the pain cake.

 

pain management Personal Health Dublin 6

Is your pain getting out of hand?

Regardless of analogies, there is a proven science to this…..

Our body house these incredible sensors which continuously send messages to the brain via electrical impulses (neural pathways). Some sensors report on temperature, some respond to mechanical change, others to chemical change. There is a certain type of wire called a nociceptor which delivers messages of danger to your brain. They respond to any form of stimulus which is considered a threat. Remember nociception is just the delivery postman of the message, not the message itself.
Not every message being delivered from the sensors reach the brain. At the level of the spinal cord there is a sorting process, and the number of messages being passed is under control. Similar to a bouncer manning a nightclub. The danger messages can sometimes be granted access and are delivered to the brain. Here the brain has to make a decision how best to react to all this information it has been given.

Dee Ryan Chartered Physiotherapist in Dublin 6 discusses the complexity of pain

Those shoes are quite nice mate…..

Next week

Next week I will discuss the various systems which the brain calls upon in its response to these issues. Similarly I will expand on the effects of pain over a prolonged period of time- known as ‘chronic pain’.
Be a friend and tag a friend who you feel will benefit from further understanding the processes involved in the pain experience!

And now my parting gift to you until next week….a superb video which explains pain in less than 5 minutes:
https://www.youtube.com/watch?v=RWMKucuejIs