Pain is a subjective experience that occurs in the somatosensory cortex of your brain. When pain receptors are stimulated, the signal travels into your spinal cord and up to your brain to be interpreted in the frontal cortex (see image). The pain pathways are part of a complicated warning system in your brain. Sometimes our brain doesn’t accurately locate the source of pain. Sensory nerves supplying different areas will share a similar pathway and enter the spinal cord through the same dorsal nerve root. The brain tends to perceive the pain signal as coming from the site where there is a higher density of pain receptors. This phenomenon is known as referred pain: pain perceived at a location other than the site of the painful stimulus. For example, pain from a heart attack is commonly experienced in the arms, chest, neck, jaw, or upper back. Thus, the specific point of pain is not necessarily indicative of the problem area or cause.
Mechanisms of chronic pain
In a structural lesion there is rigidity and tension in the muscles and ligaments of the joint. This sets up the conditions for disturbed blood flow and abnormal stimuli to the nerves in the area. The change in anatomy (structure) affects the physiology (function).
When a joint or region of the body is out of sync with the structural integrity of the body as a whole, compounding or knock-off effects occur. Joints in connection along the kinetic chain may also begin to present with restricted mobility or faulty articulation. Additionally, other areas of the body have to compensate for lack of functional movement in one part. These strain patterns can also be sources of pain, discomfort, or poor function.
To address chronic pain, Osteopathic treatment does not focus on treating only the area of pain. Instead, Osteopathic practitioners look for the cause of the collective structural dysfunction occurring in your body to get to the root of the problem.
Therapeutic Interventions for Pain Management:
The purpose of pain is to tell your body that it has been injured or is at risk of harm. Pain circuits in the brain are complex and have many connections to emotional centers and stress centers. In order to reduce pain the body must return to a state where structure is balanced and the body feels safe. Once pain pathways are stimulated, cells such as glial cells play a role in modulation, amplification, and distortion of the sensory experience. This serves a purpose by heightening the brain’s alertness. The longer the brain processes the pain, the more sensitive it becomes. The pain cycle may continue until this feedback cycle is interrupted or the initial structural deficit has been returned to normal.
Pain signals can be inhibited by endogenous chemicals in the central nervous system (opiod-like substances produced and released by your own body). These endogenous chemicals have been shown to have comparable analgesic effects to morphine but are much more potent!
Manipulative therapy has been shown to enhance pain inhibition/modulation pathways in a number of ways. Positive sensory input elicits the release of these analgesic substances and furthermore, puts the body in a state of healing. When the body is relaxed and at ease the parasympathetic nervous system over-shadows the sympathetic. Parasympathetic is the side of your autonomic nervous system responsible for “rest and digest”, where your body systems are striving for homeostasis and dedicated towards functions such as repair and nourishment. In comparison to the sympathetic nervous system, called the “fight-or-flight”, where the body’s resources are redirected towards the stress response. It is well known that stress is a health problem in the modern day because our lifestyles often induce stressful states far too often and without just cause in terms of survival purposes (we aren’t running from saber tooth tigers anymore). By promoting relaxation and steadiness of mind the body is more likely to heal and resolve pain stimuli.
Music, lighting, sounds, touch, aesthetics, and ambiance can all be used to access and promote a parasympathetic state where the body produces more pain-blocking chemicals like opioids and dopamine.
Non-noxious stimuli (non-painful stimuli) can also overload the sensory signals traveling to the brain. Try to gently massage in and around the area of pain to get some relief or try taking a hot bath. Exercise may be an effective way to override pain stimuli and it releases endorphins. However, be cautious and do not try to push through the pain as this could potentially cause further harm.
The pain response in the brain has many connections to emotional centers. Pain and emotion circuits overlap in the brain. Many studies have shown how positive thoughts and beliefs change brain chemistry. Meditation and deep breathing can change the pain perception by altering your emotional response to pain.
Osteopathic practitioners conduct their work in a way that makes the patient feel relaxed and soothed in order to appeal to the central nervous system. Moreover, Osteopaths act like mechanics to adjust the abnormal back to normal. Osteopathic treatment returns balance, harmony, and health to the body through an understanding of your unique structural pattern as a whole. By minimizing disturbances to the structural framework of the body it can work optimally as an integrated, dynamic whole.