Take a moment to think about something familiar (your pet, your grandmother, or your favorite vacation, for example.) Bring to mind the typical sensations which are present when you are in their presence (what they look like, typical smells or sounds, your typical emotions towards this person or thing.) I'd like you to close your eyes and visualize this for 30 seconds and then return to reading this article.
If we were to lay you down in an MRI and analyze the different areas in your brain which were being activated during this exercise, we would see a very similar pattern "light up" as if your grandma was actually present or if you were really on your favorite vacation again. These areas create a map in your brain's visual, emotional, memory, auditory, autonomic centers (1). Similarly, when we experience pain, a "Pain Neuromatrix" lights up as well. As seen in Figure 1 below, there are numerous areas in the brain which can create the map of pain.
Figure 1: Example of a Pain "Neurotag" or Neuromatrix; this image shows the number of areas which are typically connected during a painful movement.
This has wide ranging implications for a person's pain due to the number of areas in the brain which can be affected. For example, the amygdala (the brain's emotional processor which helps regulate anxiety, fear conditioning, emotional memory (2),) is one of the most active areas during a pain experience. Therefore, if one's pain neuromatrix is linked to anxiety, stress, or fear, then when one experiences any of these emotions it can trigger an increase in pain. The Anterior Cingulate Cortex plays a role in cognitive functions such as decision making and concentration; therefore, a disruption in this area due to its involvement in the pain neuromatrix can cause an increased difficulty concentrating on tasks consistently (1). It can even cause a sort of "brain fog". The Hypothalamus and Thalamus plays a direct role in body temperature, sleep, and hunger; therefore a disruption in this brain region can cause increased fatigue or difficulty with sleep, changes in eating habits, or inability to regulate body temperature (1).
These are serious and impactful consequences for those who have been in pain for months and years. There is good news, however. In the same way that the brain was trained to develop this pain neuromatrix, it can also be trained in the opposite direction and diminish its effects on your daily experience.
The first step to this is to learn about this process and to understand that the brain is plastic (read: changeable). We will also utilize desensitization strategies, incorporate mindfulness tactics to decrease the perception of threat and ground you in the present moment, and explore the gradual return to movement and exercise. Ultimately ending with you returning to the life you want to live.
So let's start there! What are your goals? What specific things do you want to be able to do? Reach out today and let's speak about these things and how we might be able to de-train your pain neuromatrix and return to a more mobile and healthier you.
References
1 Louw, A., Puentedura, E., Schmidt, S., & Zimney, K. (2018). Pain neuroscience education: Teaching people about pain (2nd ed.). OPTP.
2AbuHasan, Q., Reddy, V., & Siddiqui, W. (2022, July 19). Neuroanatomy, amygdala - statpearls - NCBI bookshelf. National Library of Medicine. Retrieved December 12, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK537102/
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