Updated: Oct 20, 2020
#Pain and The Mature Organism.
As a human, you own a great array of differing cells, tissues and ultimately organs. As Greg Lehman would put it- you are an ecosystem. This means that the level of processing that goes on within the body and nervous system is complex, painfully complex in fact! Millions of years of evolutionary biology has gone into establishing the human genetic sequence and ultimately your body. The brain wants to protect this valuable work at all costs. This is self-preservation tactic, not only yourself but of our species as a whole.
But Isaac, why are you getting all David Attenborough on us. Can you not just fix my back, shoulder, hip and knee!?
The answer is yes: I more than likely can. However the process will go a lot smoother with the understanding of a few key principles.
Pain to begin with has a great deal to do with the protection- of you the organism. 🏃🏽♂️ Despite what has been taught in recent years there is in fact a very poor correlation between the degree of tissue damage and resultant pain. You only need to think back to the last time you got an unsuspecting paper cut, dreadful pain for a tiny slit that will inevitably heal in a matter of hours!
Studies have shown that notable tissue changes within the body take place from an early-age. 37% of 20 year olds with NO PAIN have disc degeneration in their spine upon CT and MR imaging. (Brinjikji, 2015). Despite these natural biological changes, the majority of individuals manage to adapt and in fact stay incredibly active, fit and healthy!
Perhaps then, we need to redefine what is deemed abnormal within a clinical frame?
We commonly associate our bodily aches and pains to something being wrong with us. And oftentimes we imagine that something to be considerably bad! You have your biology and hunter gatherer origins to thank for this! Back in the days of the forest if you heard a loud noise and were not immediately running for shelter then you may well just be somebody's dinner. Our nervous system has these mechanisms deeply engrained into what is known as the limbic system buried deep in the brain stem. You may also understand this phenomenon as the "fight or flight" response.
When the body suspects there to be a problem in a certain part or region our nervous system will receive strong afferent input to warn the brain of the potential danger. Even though the tissue may well be absolutely fine it wants to double check with the brain first. However oftentimes the interpretation of this signalling is confused and this is where the ultimate problems lie. It is in our conceptualisation and fear of the pain sensation that ultimately matters. (Think back to the forest- if you aren't up and running then you are dinner.) The brain thinks, oh no there must be something seriously wrong there. It must be true, I can feel all this sensation and pain. HOWEVER as we know this signalling was only a tester, it was protective signalling only. Not a direct correlation.
Now what occurs is something that science calls somatisation. Which is a constant checking and rechecking of the status of the body part in question. This will strengthen the transmission pathways that link the brain to body! Travel down this path a few times: now it becomes coordinated and easier to walk. Welcome to the world of neural remodelling and sensitisation! Remember initially we discussed that pain is protective- the nervous system is designed to keep you safe and alive. If it is concerned or worried, these signals will reappear- just like a bad memory. 💭
So now hopefully you can see how the brain interprets data and oftentimes over exaggerates the threat and therefore potential for damage.
The great news is that our bodies are consistently taking on and ADAPTING to stress! We can learn to better manage the pain input and therefore modify our behavioural response. We can build positive habits and better control our ancient limbic systems.
Through manual therapy, graded exposure, movement variability and programmed strength/flexibility training we can down regulate a great deal of pain signalling. We can create new neural paths that push us towards healthy movement!
Our mature organism will be taken from a sensitised, cautious state to one that is more stable. 🌉
In other words, we will be harder to HURT! 💪🏼
Feel free to share this post and tag friends you believe will benefit from some extra #education!
Brinjikji et al., (2015). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology.