What’s The Deal With Pain And The Brain?
We all know how painful a paper cut can be, but thanks to your body’s ability to self-heal, before long the cut is gone! Pain is a normal protective signal that is necessary following an injury so we can take action to heal. But what if it’s been more than 3 months and your body is still in pain? We see this scenario every day at WYLD Chiropractic, and it’s known as chronic pain.
Whether you have tissue damage or not, the feeling of pain is created in your brain. Sometimes pain can persist even once the tissues have healed. It does not mean you are creating the pain; it means the brain has learnt to be in pain. This is interesting because it helps us understand why chiropractic care may improve chronic pain.
Brain scientists who have looked at the effects of chiropractic spinal adjustments, have found that adjustments may change the brain. Specifically, adjustments change the pre-frontal cortex, and it is this part of your brain that is largely involved in pain becoming chronic. Neuroscientists think that chiropractic care helps your brain ‘turn down’ or ‘switch off’ non-informative and non-helpful pain.
This means a chiropractor may or may not adjust your spine where it hurts. Instead they will adjust your spine where it lacks proper movement because the spine can’t correctly talk to your brain if it can’t move correctly. And the more your spine can talk to your brain correctly, the better your brain can accurately control your body, including only sending helpful and informative message of pain.
So if you want to get back in touch with your WYLD side, book an appointment with one of your WYLD Chiropractors to make sure your brain-body communication is as accurate as possible so you can Go Further, Go Higher, GO WYLD!
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Research suggests chiropractic care increases the healing and calming side of our autonomic nervous system, the parasympathetic nervous system!
Chiropractic Treatment
A Chiropractic adjustment, also known as chiropractic manipulation, manual manipulation, or spinal manipulation, is a common therapeutic treatment for lower back pain.
A Chiropractic adjustment refers to a chiropractor applying manipulation to the vertebrae that have abnormal movement patterns or fail to function normally.
The objective of this chiropractic treatment is to reduce the subluxation, with the goals of increasing range of motion, reducing nerve irritability and improving function.
What To Expect At Your First Visit
An initial Chiropractic exam for back pain will typically have three parts: a consultation, case history, and physical examination. Laboratory analysis and X-ray examination may be performed.
Consultation. The patient meets with the chiropractor and provides a brief synopsis of his or her lower back pain, such as:
Duration and frequency of symptoms
Description of the symptoms (e.g. burning, throbbing)
Areas of pain
What makes the pain feel better (e.g. sitting, stretching)
What makes the pain feel worse (e.g. standing, lifting).
Case history. The chiropractor identifies the area(s) of complaint and the nature of the back pain by asking questions and learning more about different areas of the patient's history, including:
Family history
Dietary habits
Past history of other treatments (chiropractic, osteopathic, medical and other)
Occupational history
Psychosocial history
Other areas to probe, often based on responses to above questions
Physical examination. A chiropractor may utilize a variety of methods to determine the spinal segments that require chiropractic treatments, including but not limited to static and motion palpation techniques determining spinal segments that are hypo mobile (restricted in their movement) or fixated. Depending on the results of the above examination, a chiropractor may use additional diagnostic tests, such as:
X-ray to locate subluxations (the altered position of the vertebra)
A device that detects the temperature of the skin in the paraspinal region to identify spinal areas with a significant temperature variance that requires manipulation.
Chiropractors are trained in a variety of methods to assess the underlying cause of the problem, including:
Evaluation and management services. Chiropractors are trained in examining the joints, bones, muscles and tendons of the spine, head, extremities and other areas of the body with the purpose of noting any misalignment, tenderness, asymmetry, defects or other problems.
Neurologic and other common physical examination procedures. Chiropractors are trained to perform a variety of neurologic tests (nerve root compression/tension, motor strength, coordination, deep tendon and pathological reflexes, etc.) and are skilled in performing orthopedic, cardiovascular and many other common examinations.
Specialised assessment. Chiropractors are trained to assess range of motion, stability, muscle strength, muscle tone and other assessments with the lower back.
Common diagnostic studies. Chiropractors are trained in use of diagnostic studies and tools such as radiography (X-rays), laboratory diagnostics and neurodiagnostics.
References
Haavik H, Holt K. (n.d.). Pain Is Created In The Brain. Retrieved July 25, 2021, from https://therealitycheck.com/wp-content/uploads/2014/01/PainiscreatedinthebrainSummaryArticleFINAL.pdf
Seymour B. Pain: A Precision Signal for Reinforcement Learning and Control. Neuron 2019;101(6):1029-41.
Koyama T, McHaffie JG, Laurienti PJ, et al. The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Sciences 2005;102(36):12950-55.
Hadjistavropoulos TD, S; Goubert, L.; Mogil J.S.; Sullivan, M.J.L.; Vervoort, T.; Craig K.D.; Cano, A.; Jackson, P.L.; Rainville, P.; Williams, A.C.; Fitzgerald, T.D. A Biopsychosocial formulation of pain communication. Psychological bulletin 2011;137(6):910- 39.
Wager TD. Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain. Science 2004;303(5661):1162-67.
Ploghaus A. Dissociating Pain from Its Anticipation in the Human Brain. Science 1999;284(5422):1979-81.
Curatolo M, Arendt-Nielsen L, Petersen-Felix S. Central Hypersensitivity in Chronic Pain: Mechanisms and Clinical Implications. Physical medicine and rehabilitation clinics of North America 2006;17(2):287-302.
Fenton BW, Shih E, Zolton J. The neurobiology of pain perception in normal and persistent pain. Pain management 2015;5(4):297-317.
Mitsi V, Zachariou V. Modulation of pain, nociception, and analgesia by the brain reward center. Neuroscience 2016;338:81-92.
Apkarian AV, Hashmi JA, Baliki MN. Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. Pain 2011;152(3 Suppl):S49.
May A. Chronic pain may change the structure of the brain. PAIN® 2008;137(1):7-15.
Costigan M, Scholz J, Woolf CJ. Neuropathic Pain: A Maladaptive Response of the Nervous System to Damage. Annual Review of Neuroscience 2009;32(1):1-32.
17. Haavik H, Murphy B. The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. J Electromyogr Kinesiol 2012;22(5):768-76.
18. Lelic D, Niazi IK, Holt K, et al. Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study. Neural plasticity 2016;2016:3704964.
19. Apkarian AV, Thomas PS, Krauss BR, et al. Prefrontal cortical hyperactivity in patients with sympathetically mediated chronic pain. Neuroscience Letters 2001;311(3):193-97.
19. Seminowicz DA, Moayedi M. The Dorsolateral Prefrontal Cortex in Acute and Chronic Pain. The Journal of Pain 2017;18(9):1027-35.
20. Kang D, McAuley JH, Kassem MS, et al. What does the grey matter decrease in the medial prefrontal cortex reflect in people with chronic pain? European Journal of Pain 2019;23(2):203-19.
21. Loggia ML, Berna C, Kim J, et al. The lateral prefrontal cortex mediates the hyperalgesic effects of negative cognitions in chronic pain patients. The Journal Of Pain: Official Journal Of The American Pain Society 2015;16(8):692-99.
23. Haavik H, Niazi IK, Holt K, et al. Effects of 12 Weeks of Chiropractic Care on Central Integration of Dual Somatosensory Input in Chronic Pain Patients: A Preliminary Study. 2017.
26. Haavik H, Murphy B. Subclinical neck pain and the effects of cervical manipulation on elbow joint position sense. J Manipulative Physiol Ther 2011;34(2):88-97.
27. Holt KR, Haavik H, Lee AC, et al. Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated With Falls Risk in Older People: A Randomized Controlled Trial. J Manipulative Physiol Ther 2016.