Our Brain and Pain!
Contributed by Andrew Lantz PT, DPT, OCS, CSCS, CMTPT
The brain is basically the CEO of the body and controls every movement that we make and has final say on what we ultimately feel. The brain has no physical access to the outside environment but it must estimate where we are in space and how well we can move in that space. So since it is an estimate - it is never 100% accurate. It is constantly being updated so it can better understand where we are in space. The brain is not a mindless painometer simply measuring units of touchiness. Some parts of the brain allow us to make objective assessments (example: the water is way too hot).
But most of the brain's responses to pain are about generating emotional responses and giving contextual interpretations about pain.
The estimations that the brain makes are estimating the body’s current capacity and abilities. The input from the body will drive the output from the brain. This is something that is always dynamic and is a reflection of how the nervous system will assign meaning to inputs whether that be form injury/stress/illness. You can think of this working like how our moods work depending on current (and past) input.
Have a time crunch at work or kids not listening —> output could be moodiness or a short temper. On the beach on a sunny warm day —> output in mood will be calm.
Our nervous system works in a similar way. If it is overstressed or overtaxed, a normal non-threatening or non-painful input could be overestimated or exaggerated and become quite painful. Understanding how this works can work to our advantage. In the clinic as we work to desensitize overstressed or hyperirritable tissue and effect an overall calming on the entire nervous system. We do this via breathing, exercise, and the practice of mindfulness.
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