Pain Alarm System

Pain is our Alarm System

by

When some of the parts of your brain get particular messages in a specific pattern, the brain decides for you to make you feel pain to warn you that something might not be right, that you may be in danger.

Chiropractic helps your brain know what is going on in the spine and body

Sympathetic and parasympathetic system

When your alert and danger (sympathetic) system is really active your heart beats faster, your brain mobilizes your bodies energy stores and you become more alert and vigilant and you even sweat more. When the alert and danger (sympathetic) system is more settled your calm & healing (parasympathetic) system takes over. This allows your brain and body to calm down, to heal tissue cells and to digest your food properly.

Prefrontal Cortex

Scientists have shown that chiropractic care changes the function in your prefrontal cortex – one of the brains orchestra conductors. This is also probably why chiropractic care helps people who are suffering with pain – by changing the pain music in the brain itself.

Video Transcript

There are millions of tiny sensors all around your body.1 They are at the ends of the thousands of nerve cells you have.1 Some of these sensors respond to mechanical forces such as stretch or touch. 2 Some of these sensors respond to temperature, both hot and cold.1 Others respond to chemical changes on the inside or outside of your body.3 For example, some chemical sensors respond to capsaicin,3 the active ingredient in chili peppers,3 and others respond to spider or snake venom.4 There are also chemical changes that take place inside your body that chemical sensors respond to, such as inflammation5. There are other sensors too like your eyes, your ears, your nose, tongue and so on.

All of the information from all of these sensors gets sent to your central nervous system, so that your brain can figure out what is going on inside and outside your body6 7 . The easiest way to think about how this all works is to think of your nerves like musicians with different instruments (the instruments are the sensors), and all of these musicians play their tune so your brain can listen to what’s going on in and around your body. So, some play a sound information tune, some play a visual information tune, some play a touch tune, and so on. All of these tunes get put together in your brain so it becomes like an orchestra playing a symphony that your brain is listening to.7 To make sure that these tunes come together in harmony, so your brain can make sense of them, your brain needs a conductor for its orchestra. Your brain actually has a number of conductors that work together, and one of these conductors is called your pre-frontal cortex.8 9 This particular part of your brain is very sensitive to changes in spinal function and is affected specifically with chiropractic care.10 11

When some parts of the brain get particular messages in a specific pattern – the brain decides for you it should make you feel pain – to warn you that something might not be right – that you may be in danger.12-16 A number of parts of your brain are involved in playing this particular pain music, including your prefrontal cortex,17 and other parts of your brain that are together known as the Pain Matrix.18 19

But your brain can play many tunes, not just a pain tune. The brain can also learn new tunes. Your nerve cells talk to each other through little connections called synapses5. These synapses can be talking non-stop or totally silent. But how these nerves talk to each other determines what music your brain will hear.

Each synapse is surrounded by an immune cell which can influence the synapse itself as well as about 100,000 surrounding synapses.20 All of these synapses work together in a very complex way which means that all of the different systems in your body can influence the music that your brain will play, such as the pain tune. What we know from decades of pain research is that through this complex interaction, your brain can actually learn to be in pain, particularly if you pay a lot of attention to the pain tune. 21-23

Sympathetic vs Parasympathetic

Within your entire nervous system you have two important sub-systems that impact the pain tune in a big way.24 The alert & danger system and the calm & healing system. You may have heard of them as the sympathetic system and the parasympathetic system.25 When your alert& danger (sympathetic) system is really active your heart beats faster, your brain mobilizes your bodies energy stores and it prepares your big muscles for a fight or to run away.25 You also become more alert and vigilant and you even sweat more.25

When the alert& danger (sympathetic) system is more settled your calm& healing (parasympathetic) system takes over25 This allows your brain and body to calm down, to heal tissue cells and digest your food properly.26

When your brain plays the pain tune your alert & danger (sympathetic) system will activate.27 Your muscles will tighten up and blood is diverted away from digestion, reproduction and healing. 28 This is great if you have an immediate threat you need to respond to, but this can become a problem if you are in chronic pain, because this means you will have persistent high levels of adrenaline pumping through your body27 29 30. This high level of adrenaline over long periods of time can change your nerves and contribute to amplifying the danger/pain matrix tune in your brain – making the danger pain signals seem greater and making them more constant.31

This pain tune, created by your brain is your brains way of trying to protect you from danger.32 So when your ‘alert & danger’ (sympathetic) system has been activated your brain primes your big muscles for action.25 For example your hamstrings and quadriceps, your trapezius, biceps and triceps all get ready for you to fight or run away from the situation. This is great if there is a threat you need to fight or run away from – like a saber tooth tiger! But if you are under long-term, modern-day stress, this is no longer so good for you. These big muscles that have been primed, if they don’t actually get a work out from fighting or running away, can over time start to feel sore and stiff. 33 What also happens is that when these big muscles get primed for action, the little muscles, for example the small muscles closest to your spine and skull, they go to sleep,34 because there is no use for them if you are trying to avoid the saber tooth tiger.

So, if you are suffering from chronic pain the orchestra in your brain is stuck on one tune – the pain tune. 26 It’s important then to remember that your brain is capable of playing thousands of other tunes – not just pain – and your brain can be trained out of playing only the pain tune. If you are under chronic stress and in chronic pain, then exercising your big muscles is very important because you need to get them working properly again. It’s also very important to go see your chiropractor regularly to keep those small muscles surrounding your spine and skull active and moving well.10 These small muscles do in fact play a very important role – they tell your brain what your spine is doing, which represents what the core of your body is doing.10 If that communication between your spinal muscles and your brain becomes distorted, you end up with a communication breakdown between your brain and your body.10 Not only will your brain not know what is going on in your spine, but if your small paraspinal muscles are not working properly your brain also struggles to ‘see’ what is going on in the rest of your body, like your arms and legs.10 This might lead to accidents and the development of more pain and problems.10

Remember that chiropractic care is already well known in the research literature to help people who suffer with back pain,35-38 neck pain39-41 and some types of headaches.42-44 This is most likely because chiropractic care helps your brain know more accurately what is going on in the spine and body and may help your brain to switch off feelings of pain, when they are no longer needed.10 Remember also that scientists have shown that chiropractic care changes the function in your prefrontal cortex – one of the brains orchestra conductors.11 This is also probably why chiropractic care helps people who are suffering with pain – by changing the pain music in the brain itself.10 Don’t forget though that chiropractic care has so much more to offer than just helping you with your chronic pain. Chiropractic care is all about improving the communication between your brain and body so you can function at your optimal potential.10

However, if you do suffer with chronic pain, do your best to stay positive, 45 move often, 46 47 eat well, 48 49 sleep well,50 and go see your family chiropractor51 52 to have your brain’s conductor fine-tuned too.

References
  1. Gray H. Gray’s anatomy: the anatomical basis of medicine and surgery. 38th ed. London: Churchill Livingstone 1995.
  2. Brumagne S, Cordo P, Lysens R, et al. The Role of Paraspinal Muscle Spindles in Lumbosacral Position Sense in Individuals With and Without Low Back Pain. 2000;25(8):989-94. doi: 10.1097/00007632-200004150-00015
  3. Szolcsanyi J. Effect of capsaicin on thermoregulation: an update with new aspects. Temperature (Austin, Tex) 2015;2(2):277-96. doi: 10.1080/23328940.2015.1048928 [published Online First: 2016/05/27]
  4. Bohlen CJ, Julius D. Receptor-targeting mechanisms of pain-causing toxins: How ow? Toxicon : official journal of the International Society on Toxinology 2012;60(3):254-64. doi: 10.1016/j.toxicon.2012.04.336 [published Online First: 04/14]
  5. Moller AR. Sensory systems: Anatomy and Physiology. California: Elsevier Science 2003.
  6. Morasso P, Sanguineti V. Self-Organizing Body Schema for Motor Planning. Journal of Motor Behavior 1995;27(1):52-66. doi: 10.1080/00222895.1995.9941699
  7. Lackner JR, DiZio P. Vestibular, Proprioceptive, and Haptic Contributions to Spatial Orientation. Annual Review of Psychology 2004;56(1):115-47. doi: 10.1146/annurev.psych.55.090902.142023
  8. Kane MJ, Engle RW. The role of prefrontal cortex in working-memory capacity, executive attention, and general fluid intelligence: An individual-differences perspective. Psychon Bull Rev 2002;9(4):637-71. doi: 10.3758/bf03196323
  9. Rossi AF, Pessoa L, Desimone R, et al. The prefrontal cortex and the executive control of attention. 2009;192(3):489-97. doi: 10.1007/s00221-008-1642-z
  10. Haavik H, Kumari N, Holt K, et al. The contemporary model of vertebral column joint dysfunction and impact of high-velocity, low-amplitude controlled vertebral thrusts on neuromuscular function. European Journal of Applied Physiology 2021:1-46.
  11. 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
  12. Apkarian AV, Bushnell MC, Treede R-D, et al. Human brain mechanisms of pain perception and regulation in health and disease. European journal of pain 2005;9(4):463-84.
  13. 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. doi: 10.1073/pnas.0408576102
  14. Ploghaus A. Dissociating Pain from Its Anticipation in the Human Brain. Science 1999;284(5422):1979-81. doi: 10.1126/science.284.5422.1979
  15. Wiech K. Deconstructing the sensation of pain: The influence of cognitive processes on pain perception. Science 2016;354(6312):584-87. doi: 10.1126/science.aaf8934 [published Online First: 2016/11/05]
  16. Wager TD. Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain. Science 2004;303(5661):1162-67. doi: 10.1126/science.1093065
  17. 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. doi: 10.1016/j.jpain.2015.04.003
  18. Seminowicz DA, Moayedi M. The Dorsolateral Prefrontal Cortex in Acute and Chronic Pain. The Journal of Pain 2017;18(9):1027-35. doi: https://doi.org/10.1016/j.jpain.2017.03.008
  19. Fenton BW, Shih E, Zolton J. The neurobiology of pain perception in normal and persistent pain. Pain management 2015;5(4):297-317. doi: 10.2217/pmt.15.27 [published Online First: 2015/06/20]
  20. Kimelberg HK, Nedergaard M. Functions of astrocytes and their potential as therapeutic targets. 2010;7(4):338-53. doi: 10.1016/j.nurt.2010.07.006
  21. 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.
  22. 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. doi: 10.1037/a0023876
  23. Mitsi V, Zachariou V. Modulation of pain, nociception, and analgesia by the brain reward center. Neuroscience 2016;338:81-92. doi: 10.1016/j.neuroscience.2016.05.017
  24. 24. Laird RA, Keating JL, Ussing K, et al. Does movement matter in people with back pain? Investigating ‘atypical’ lumbo-pelvic kinematics in people with and without back pain using wireless movement sensors. BMC Musculoskelet Disord 2019;20(1):28. doi: 10.1186/s12891-018-2387-x [published Online First: 2019/01/20]
  25. 25. Cardinali DP. Autonomic Nervous Sytem: basic and clinical aspects. Switzerland: Springer International Publishing 2017.
  26. Kolb B, Whishaw IQ. BRAIN PLASTICITY AND BEHAVIOR. Annual Review of Psychology 1998;49(1):43-64. doi: 10.1146/annurev.psych.49.1.43
  27. Hannibal KE, Bishop MD. Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy 2014;94(12):1816-25.
  28. Brown RA. Spinal Health: The Backbone of Chiropractic’s Identity. Journal of Chiropractic Humanities 2016;23(1):22-28. doi: https://doi.org/10.1016/j.echu.2016.07.002
  29. McManus C. Chronic Stress, Chronic Pain, and the Corticolimbic System. Orthopaedic Physical Therapy Practice 2019;31(1):50-53.
  30. Vachon-Presseau E. Effects of stress on the corticolimbic system: implications for chronic pain. Progress in Neuro-Psychopharmacology and Biological Psychiatry 2018;87:216-23. doi: https://doi.org/10.1016/j.pnpbp.2017.10.014
  31. Melzack R. From the gate to the neuromatrix. Pain 1999;82:S121-S26. doi: 10.1016/s0304-3959(99)00145-1
  32. Seymour B. Pain: A Precision Signal for Reinforcement Learning and Control. Neuron 2019;101(6):1029-41. doi: 10.1016/j.neuron.2019.01.055 [published Online First: 2019/03/22]
  33. Sjøogaard G, Lundberg U, Kadefors R. The role of muscle activity and mental load in the development of pain and degenerative processes at the muscle cell level during computer work. European Journal of Applied Physiology 2000;83(2-3):99-105. doi: 10.1007/s004210000285
  34. Butler D, Moseley AM. Explain Pain. 2 ed: Noigroup Publications 2013.
  35. Ruddock JK, Sallis H, Ness A, et al. Spinal manipulation vs sham manipulation for nonspecific low back pain: a systematic review and meta-analysis. Journal of chiropractic medicine 2016;15(3):165-83.
  36. Goertz C, Pohlman K, Vining R, et al. Patient-centered outcomes of high-velocity, low-amplitude spinal manipulation for low back pain: a systematic review. Journal of Electromyography and Kinesiology 2012;22(5):670-91.
  37. Hidalgo B, Detrembleur C, Hall T, et al. The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews. Journal of Manual & Manipulative Therapy 2014;22(2):59-74.
  38. Paige NM, Miake-Lye IM, Booth MS, et al. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: systematic review and meta-analysis. Jama 2017;317(14):1451-60.
  39. Bryans R, Decina P, Descarreaux M, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. Journal of manipulative and physiological therapeutics 2014;37(1):42-63.
  40. Wong JJ, Shearer HM, Mior S, et al. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. The Spine Journal 2016;16(12):1598-630.
  41. Gross A, Miller J, D’Sylva J, et al. Manipulation or mobilisation for neck pain: a Cochrane Review. Manual therapy 2010;15(4):315-33.
  42. Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of manipulative and physiological therapeutics 2011;34(5):274-89.
  43. Rist PM, Hernandez A, Bernstein C, et al. The impact of spinal manipulation on migraine pain and disability: a systematic review and meta‐analysis. Headache: The Journal of Head and Face Pain 2019;59(4):532-42.
  44. Fernandez M, Moore C, Tan J, et al. Spinal manipulation for the management of cervicogenic headache: A systematic review and meta‐analysis. European Journal of Pain 2020;24(9):1687-702.
  45. Schutze R, Rees C, Slater H, et al. ‘I call it stinkin’ thinkin”: A qualitative analysis of metacognition in people with chronic low back pain and elevated catastrophizing. British journal of health psychology 2017;22(3):463-80. doi: 10.1111/bjhp.12240 [published Online First: 2017/04/05]
  46. Booth J, Moseley GL, Schiltenwolf M, et al. Exercise for chronic musculoskeletal pain: A biopsychosocial approach. Musculoskeletal care 2017;15(4):413-21. doi: 10.1002/msc.1191 [published Online First: 2017/04/04]
  47. O’Connor SR, Tully MA, Ryan B, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Archives of physical medicine and rehabilitation 2015;96(4):724-34.e3. doi: 10.1016/j.apmr.2014.12.003 [published Online First: 2014/12/23]
  48. Masino SA, Ruskin DN. Ketogenic diets and pain. Journal of child neurology 2013;28(8):993-1001. doi: 10.1177/0883073813487595 [published Online First: 2013/05/18]
  49. Silva AR, Bernardo A, Costa J, et al. Dietary interventions in Fibromyalgia: a systematic review. Annals of medicine 2019:1-29. doi: 10.1080/07853890.2018.1564360 [published Online First: 2019/02/09]
  50. Burgess HJ, Burns JW, Buvanendran A, et al. Associations Between Sleep Disturbance and Chronic Pain Intensity and Function: A Test of Direct and Indirect Pathways. The Clinical journal of pain 2019 doi: 10.1097/ajp.0000000000000711 [published Online First: 2019/03/27]
  51. Goertz CM, Pohlman KA, Vining RD, et al. Patient-centered outcomes of high-velocity, low-amplitude spinal manipulation for low back pain: a systematic review. J Electromyogr Kinesiol 2012;22(5):670-91. doi: 10.1016/j.jelekin.2012.03.006 [published Online First: 2012/04/27]
  52. Ruddock JK, Sallis H, Ness A, et al. Spinal Manipulation Vs Sham Manipulation for Nonspecific Low Back Pain: A Systematic Review and Meta-analysis. J Chiropr Med 2016;15(3):165-83. doi: 10.1016/j.jcm.2016.04.014 [published Online First: 2016/09/24]

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