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Control Pain & Heal Faster With Your Brain


Key Takeaways

  • Inflammation has a bad reputation but an immediate, acute inflammation response is good and allows the body to repair tissue

  • Chronic, unchecked inflammation is bad

  • Neuroplasticity allows our nervous system to change itself in response to experience which impacts how we experience pain

  • Pain is complex because there is a subjective component

  • “Pain is a belief system about what you’re experiencing in your body.” – Dr. Andrew Huberman

  • Visualization exercises using imagery to imagine the amputated limb have been shown to reduce phantom limb pain

  • To overcome motor injury: restrict use of the uninjured limb and force (within reason and safety) use of an injured limb

  • The glymphatic system is key in clearing out debris that surrounds injured neurons in traumatic brain injury

  • To better activate the glymphatic system: (1) sleep on the side instead of stomach or back; (2) sleep with feet slightly elevated; (3) 30-45 minutes of Zone 2 exercise 3x/week

  • Key components of injury/tissue rehabilitation: sleep, short walk, heat more than ice, sunlight

Somatosensory System

  • Neuroplasticity allows our nervous system to change itself in response to experience

  • Somatosensory system: system involved in understanding touch and physical feeling on the body

  • Sensors that reside in skin and deeper layers respond to mechanical touch, heat, cold, vibration, etc.

  • Receptors send information via axons down spinal cord and to the brain

Controversy Of Pain In Neuroscience

  • Pain has a physical and mental component

  • Pain has a perceptual component – “pain is a belief system about what you’re experiencing in your body.” – Dr. Andrew Huberman

  • Nociception: physiological term which describes the mechanism without the emotional component

  • Understanding pain offers systems we can leverage to understand the difference between pain and injury

  • There can tissue damage (e.g. radiation, x-rays) without physical sensation of pain

  • There can be pain without tissue damage – visual image of something we perceive as painful can give feeling of pain

  • Pain has some genetic component and some adaptive role

  • Plasticity of perception has significant impact on emotion pain and trauma

Subjective Aspect Of Pain Modulation

  • The pain system is subject to perceptual influences

  • Our interpretation of an event is powerful dictating our experience of the event

  • Adrenaline blunts experience of pain

  • People who anticipate an injection of morphine report reduced pain because they know the relief is coming

  • Feeling of love, infatuation, obsession – internally blunts pain response possibly because of dopamine release

  • Looking at an image of a loved one allows people to reduce pain response and raises threshold for pain

Homunculus

  • Homunculus is a representation of the body surface which is scaled in a way that matches the sensitivity

  • Homunculus shows the size of brain area as related to density of receptors, not physical area

  • Areas of the body with more dense receptors will be more sensitive to pain than others

  • More receptors = more blood vessels and glia that respond to inflammation

Phantom Limb Pain

  • Phantom limb pain: sensation of removed/amputated limb in the position it was at the time of trauma

  • Representation of hand is intact in the cortex and it’s trying to make sense of proprioceptive feedback

  • Potential treatment: use the mind to control the perception of what’s happening in the body

  • Mirror box visualization exercise: place intact limb in a box with mirrors and visualize opposite (removed) limb to remap brain’s image of body surface

  • Patients who performed mirror box visualization reported immediate relief of pain

Overcoming Motor Injury

  • Atrophy happens because nerves sending signals to muscles are inactive so muscles don’t contract

  • If there’s damage to sensory-motor pathways or limb, there’s a benefit to restricting the use of an uninjured limb

  • Restrict movement of intact, uninjured limb to force some movement in injured limb and increase plasticity in the brain

  • Imbalances between the right and left body quickly become exaggerated if use is restricted

  • Senses and movement are competing for space in the brain so we need to respect the competition

  • Encourage activity of injured limb, as much as possible without pain or further injury

  • Recovery is faster in patients who restrict the use of uninjured limb and safe use of an injured limb

  • Examples: in a shoulder injury perform some reaches, with a knee injury gently ride a stationary bike to equally work both sides

Traumatic Brain Injury (TBI)

  • TBI can cause general degradation of brain function

  • Symptoms of TBI: headache, photophobia, mood changes, sleep disruption

  • The brain has a heightened capacity for repairing itself earlier in life versus later

  • Try to avoid a second TBI if you have had one

  • The glymphatic system in the brain clears out debris that surrounds injured neurons

  • Most activity of glymphatic system happens during the earlier part of the night during slow wave sleep

  • Two methods of glymphatic system activation: (1) sleeping on the side instead of back or stomach; (2) sleep with feet slightly elevated

  • Exercise for improved glymphatic system function: zone 2 cardio (low-level cardio) like a light jog, walk, an easy bike ride – 30-45 minutes 3x per week

Acupuncture & Inflammation

  • Acupuncture uses needles to stimulate electricity in the body

  • Acupuncture illuminates cross-talk between the somatosensory system and autonomic nervous system

  • Acupuncture can modulate pain and inflammation but there has to be a systematic understanding of the effect you are trying to achieve

  • Certain patterns of intense stimulation of the abdomen can liberate immune cells and counter infection

  • Stimulation of feet and hands at low intensity can reduce inflammation

  • There are real maps of our body surface that interact with our molecules and stimulate or reduce inflammation, blunt response to pain, increase (good) inflammation

  • Not all inflammation is bad: inflammation is a tissue repair response – it calls cells to the site of injury to treat

  • Inflammation has a negative connotation because unchecked or chronic inflammation is bad

Directing Plasticity Toward Specific Outcomes

  • Wim Hof breathing and ice baths release adrenaline and can counter infection but you want to dose and regulate the release

  • Adrenaline and inflammation is adaptive at the moment

  • Short term plasticity can make us better able to cope with an acute event

Necessities For Injury/Tissue Rehabilitation

  • Sleep is essential – 8 hours of sleep or at least 8 hours immobile

  • Walk 10-min per day unless it exacerbates the injury

  • Ice numbs the environment of injury and has a placebo effect but also has negative effects that may offset the use

  • Ice can restrict movement out of the injury site

  • Heat can improve the viscosity of tissues and improve blood and damage out of the area

  • Sunlight may be as effective as red light

Platelet Rich Plasma (PRP), Stem Cells, & Baby Blood

  • PRP has never been shown to have an effect itself

  • The number of stem cells in PRP is minimal

  • Stem cell technology is on the horizon but needs much more research

  • The concern is stem cells can become a number of things so it’s difficult to know the safety for a specified area

  • Blood from umbilical cords has been shown to vitalize brain tissue in mice

  • It’s possible that young blood may be used to treat neurological pathologies in the future


 

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