Episode #15- Neuroscience- A New Way to Understand Pain

In this episode we will review the traditional view of pain (signals from your body to your brain), and compare that with what neuroscience teaches us about pain.  Our brains adapt and change when pain is chronic, and much of the pain that is really felt in the body is originating from the brain.  This does not mean it is all in your head, it just means your brain is causing some of the effects in your body interpreted as pain.  Pain can be a physical sensation, but can also behave just like an emotion.

 

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Transcript:

This is Betsy Jensen, and you are listening to Unstoppable Body and Mind—Episode 15–Neuroscience:  A New Way to Understand Pain.

 

In this podcast we learn to upgrade our brain and understand the power of our thoughts, to heal and to create the results we want in our life. Become the person in control of your healing and make peace with your life.  Become unstoppable, body and mind.

 

Hello, today we have a fun, exciting, well it is for me, and educational episode about neuroscience, which is basically the study of the brain and what we can learn from neuroscience about pain. But I want to start by going back thousands of years to the 1600s when Descartes and the society at the time decided the mind and body were separate entities. So the mind was the focus of the religious pursuits and knowledge, and the body became the subject of science. So the study of the body and the brain from the scientific worldview would be to measure the things we could quantify and look on smaller and smaller levels as different tools of perception were invented— microscopes and ways to perceive what was going on down to the very cellular or microscopic level. I kind of like to use the analogy when talking about traditional science and neuroscience, of Newtonian physics versus quantum physics. 

 

If I lost you there, stay with me. So Newtonian physics is very cause and effect and it's true, but it's very simple. Quantum physics began when scientists were able to study light. And they found that light was acting like a wave sometimes or like a particle sometimes, depending on how it was being measured. So basically there is an observer effect. Quantum physics is not as straightforward and cut and dry as Newtonian physics because there's an acknowledgment of even the effect of something external on the situation, which was not originally acknowledged. In quantum physics we learn that both light and matter have wave-like properties. So since we are made of matter, that means we, as solid as we may appear, have wave-like properties because we are made up of atoms, and atoms are made up of subatomic particles and subatomic particles are made of energy. 

 

Basically, we and all of the things around us are made up of energy. It's just the building blocks of all of the matter in the world. So things around you that look very solid, like a brick in your house, or your phone, or an animal or a tree are all made up of the same type of energy that is in your body. It's all the same, and it's always flowing and changing all the time. So in Newtonian physics, you are measuring and studying the physical world—the world of matter. In quantum physics, you include the study of energy and the realization that actually just by measuring things, we are influencing the outcome of it. 

 

So how does this compare to the perception of pain in the traditional model vs pain through the eyes of neuroscience? So to put it in an extremely simple way, the view of pain in the traditional, or medical, model is that there is a structure in your body that senses pain. And then it sends signals to your brain, and the brain interprets them as pain. And this is how you feel physical pain. So the solution for pain is to examine the area where the pain occurs and treat the symptoms. 

 

And physiological things like pain are from physiological causes. So you could take some medicine to correct the problem. Like if you had inflammation, you could take an anti-inflammatory there, or we can work with imaging techniques, such as x-rays or MRIs and see if there is some kind of structural problem that looks bulging, or ruptured or torn. And you could have surgery to fix any abnormalities. 

 

As medicine developed, there began to be specialists in each area of the body. So the body was subdivided into even further parts and examined in this very physical way. If you had pain in your stomach, you might see a GI specialist. Or if you had heart issues, you would go to a cardiovascular specialist. For me, since I was a physical therapist, I was mainly trained in musculoskeletal issues, or orthopedic issues. Pain is looked at as something that's broken in the body that should be fixed. 

 

Neuroscience teaches us that this is different. The brain actually contributes a lot, not just interpreting the pain signals as originally thought, but actually in creating pain. Dr. Bethany Ranes of the UnitedHealth Group Chronic Pain project says your brain is not a passive organ that lives up in your head. It is deeply involved with all aspects of your body's functioning and pain is no different in this model. You don't divide the body parts and organs into separate little functioning microcosms. The mind and nervous system are all working together. Nociceptive pain, or nociceptive signals, are kind of how we would view traditional thoughts about pain, the pain that comes from the body, this bottom-up approach, the nervous system that sends the signals up to the brain where it is processed. So the physiological approach to pain, that's nociceptive pain. This is traditionally more acute pain. So if you cut yourself or you sprain your ankle, there is some sensation that your body is receiving because of the injury, that it transmits up to the brain, and you feel pain from that. 

 

But with neuroscience, we learned that pain can also be a top-down process. So your mind is initiated. Pain, it syncs together with the body, it seamlessly is choreographed by the body. And even though there is no bodily initiation of the pain, it is still perceived as pain in the body coming from the mind. And it's important to remember that this pain is not imaginary. It's not just perceived. But if you imagine the brain, starting some neuron pathways, and then releasing neurotransmitters into the bloodstream, those neurotransmitters can have physiological effects on the body, which do create pain, but it was started from the brain. The pain signals start in the brain and take effect in the body. So pain is bi directional. It can be from sensory information from the bottom up, and it can be from the top down. So the behavior of the mind is able to influence the environment of the body. Just like in quantum physics, the behavior of someone measuring or someone's intent has an effect on what they're trying to measure.

 

And this type of pain created by the mind is not generally looked at. And most chronic pain is this type of pain. It's this top-down pain. It's our brain’s attempt to protect us in a way, keeping us in pain, and keeping us on the alert for more causes of pain. Now, our bodies naturally are very amazing at healing. If you have something like a severely sprained ankle, or even a broken bone, that can heal in about six weeks. So if you're having pain that's lasting years, or even decades, you're not just receiving those pain signals from your body. It's not just a signal that something in your body is broken. You have some of the pain that's originating from these protective measures of your brain. 

 

We know that studies have shown healthy people having no back pain that receive MRIs, 80% of them do show degenerative changes in their spine, but they're not feeling any pain from this. So we know that even things like bulging discs, ruptured discs, torn rotator cuffs, all of these physical abnormalities can actually just be structural abnormalities that don't cause pain. Dr. Tim Flynn refers to them as wrinkles on the inside. So think about when we age, we get gray hairs and wrinkles. And just like the wrinkles on the outside don't hurt physically, things like arthritis, degeneration, tears, bulges, scoliosis, having a vertebrae that's tilted—there are lots of studies showing no correlation between these types of degenerative changes and how people perceive pain. You'd think if you look through this medical microscope, that if your knee shows more arthritis, that means you'll feel more pain. But this is just not proven to be true. So they estimate that only 1% to 5% of chronic pain cases are from a purely physiological reason. Yet that's what all of our treatments are focused on. Most people report that when their doctor tells them that their MRI has some sort of abnormality, and that there's a diagnosis, that they have an increase in pain. So this alone suggests there's more going on than just the physical symptom. 

 

Another way we know that arthritic or other degenerative changes aren't felt the same by everyone is with placebo studies. There was a study in which lower back pain patients received a saline solution injection instead of an injection that had steroids in it. But when they believed they were receiving some medicine that would help their back, many of them reported a relief in their symptoms. Now, this one is crazy. There was a study with people with knee arthritis, and they told all of them that they were going to have an arthroscopic knee surgery, or a scope. So some of the people had a fake surgery—they didn't even have the surgery performed. They just got cut open and sewn back up and told that the surgery was a great success. And guess what? A significant number of the people who had this sham surgery still reported that their knee felt better after the procedure. There's no way the purely physical model could account for this. If a doctor can't find something physical, yet the patient still has pain, this can be very stressful, and the patient could feel like they have something to prove, or they could feel frustrated. If we only think of pain as something wrong or broken with our physical body, then that can be extremely frustrating when there's nothing physical they can find.

 

Some diagnoses have pain that moves around to different parts of the body. And sometimes people will have some short-term success with a surgery or a new treatment only for that pain to return. The purely biomedical model does not explain this, but neuroscience can. Neuroscience teaches us that pain involves memory, association, social aspects, perceptive aspects, affect and emotional aspects. Dr. Bethany Ranes says pain is more aligned with an emotion than anything else. What pain is like an emotion? Isn't that cool to think? I thought that was really awesome because it's not just these nociceptive signals from our body. Pain is complex. It involves our history, our perception, our worries, our fears and how everything plays together in our body. Even physical pain can be considered an emotion. Just like you may feel an emotion in your heart, you might feel an emotion in your body, and they are just the same. 

 

A neuroscientist, Dr. Tor Wager, studied the pathways of rejection. So when people were feeling the emotion of rejection, he found it activated very similar pathways in a similar area to the brain as people feeling the pain pathway. Again, more evidence that pain is like an emotion and can come from this top-down approach. This was super exciting for me to find out because with my study of the Life Coach School, and knowing the model, I've been really studying emotions and learning a lot about emotions. And of course, we know that our feelings or emotions come from our thoughts. And this is exactly what neuroscience teaches. A thought, which is that neuronal, electrical communication that starts in the brain, can produce neurotransmitters, so hormones like dopamine or cortisol. In Molecules of Emotion, by Candace Pert, she teaches that these neuropeptides are things that cause us to feel emotion. So when neurotransmitters connect to their receptor sites, there is a vibration. The molecules shimmy, and sway, and vibrate and move. So as I've been taught, and it all makes sense now, emotions are vibrations in our body. And the majority of chronic pain is like an emotion created by our brain that we feel in our body. Remember when I told you I thought of neuroscience like quantum physics, and you remember in quantum physics, how we're all made up of energy, we're all made up of these wave-like forms that are constantly moving and changing. It's these vibrations.

 

Now, what I think is really cool is combining this knowledge with the map of consciousness by Dr. David Hawkins, where there's a chart that shows all of the vibrational frequencies of different emotions measured in hertz. So from a scale of 0 to 1000, he gives you the equivalent vibrational frequency of each emotion. So actually 0 is death. There's no emotion there, but very close to the lowest vibration possible is shame at 20, guilt is 30, apathy is 50, grief is 75; fear, desire, anger and pride are all vibrational frequencies under 200. This means that they are considered a destructive energy, it's negative, it has to get its energy from somewhere, either draining the people around you or getting energy from your own body in the form of disease. These are primarily emotions that are felt when you're in fight or flight. So when you're primarily in any of these emotions, especially the very low ones, guilt and shame, it's literally a state where your body is unable to heal itself. And what you must focus on is getting from that fight or flight mode to one of the higher vibrational frequencies—the state of calm for your body where the parasympathetic system takes over, where you're no longer in high alert, and you're able to literally rest, and repair and heal your body. 

 

Our society teaches that when we have negative emotions, we try to solve them by changing something in our outside world. So if we're sad, we might want to buy something. Or if we're angry, we want to change someone else or yell at them. We're also taught to control pain by changing things in our physical bodies. So taking medicine or doing treatments, maybe just having surgery. But what if our pain could be telling us something? What purpose does pain serve? If we burn our hand on a hot stove, we will learn not to touch it again. We don't want that recreation of pain. And since we create things in our bodies with our mind, we know that neuroplastic pain can be pain created by a brain to keep us from doing something, from being vulnerable to experiencing emotions that might be harmful. 

 

Here are four main ways the brain creates and amplifies pain signals to our body. The first is prediction. Our brains are very adept at putting together information from our past and projecting it into our future. So to try to anticipate any pain that might originate from the environment, if it seems similar to an environment we've had pain in before, and we'll just recreate that pain without the environmental cause actually being there just by anticipating it. So I think of it as a tickling game I used to play with my siblings, where we'd hold someone's arms up and come in closer and closer, slowly wiggling our fingers and usually about an inch away from the armpit or so is when someone would start squirming, and laughing and reacting as if they've been tickled. Even though there was actually no physical touch, even touching their body. It's this anticipation and the recreation of the physical sensation purely from your brain alone. 

 

Here's another example of how the brain creates pain through prediction. It's like the placebo effect, but it's called the nocebo effect. So for example, when cancer patients who were going to receive chemotherapy were told the chemotherapy would likely make them nauseous, then 50% of them upon just driving to their treatment began to feel nauseous in anticipation. Another nocebo effect trial included women who were given a pill that was supposed to have a side effect of making their PMS worse. 70% of them did report increased PMS symptoms with the sugar pill. The way our brain tries to predict pain based on the environment can even be seen in this study with anesthesiologists who in one group were very kind and nice and said things were going to go well and positive with the patients. And in the second group, they were very short and grumpy and didn't seem to give their patients very much care. And the success rates of the surgery and their recovery were much higher in the group that had the nice anesthesiologist. It's like their brain predicted from the environment from the input they were given that they would heal normally. And then they did. 

 

The second way the brain creates pain signals is by central sensitization. So in this case, the nervous system becomes highly reactive. The nervous system, it's like it's hypersensitive, it doesn't take much to set it off. So it takes less and less of an actual stimuli to elicit pain. So maybe when the pain begins, you're able to raise your arm 90% of the way over your head. But as the pain continues, you start to feel that pain even before you reach that part of your range of motion; maybe even thinking about moving your arm causes some pain. Your brain is totally in control of how sensitive you are to pain. And it could take very little to set your pain off. Your brain can even generalize if you feel pain under a stressful situation. Then the next time you have a stressful response in your body, you also produce that body pain signal. And again, thinking back to that chronic stress or fight or flight mode. If your nervous system is working overtime, your body is not able to rest and repair and it's more able to perceive things as painful. Our brain can conceive that this is less dangerous for us. If we are not putting ourselves out there and being vulnerable and trying new things, but instead are kept small and kept stuck from our pain, then we won't run that risk of being hurt in the future. 

 

The third way your brain produces pain for your body is by pain catastrophizing. This one is hard. It is so ironic, because when people are in pain, they tend to want to focus on their pain, especially the more pain they have. But what research has shown is that when you focus your intention on your pain, how awful it is, how hopeless you feel when you worry about it, when you're paying attention to it and ruminating on it, then you light up the same regions of the brain that are involved in the processing of pain itself. So we are literally growing pain in our body by placing our attention and focus and thought patterns on our pain. Dr. Beth Darnall says if we don't understand how these pieces fit together, and we're not using the right skills, we are unwittingly increasing our pain. I like to think of the equation that pain times resistance equals suffering. So there is a certain amount of pain. But the more we resist it, the more suffering we have. When we focus our thoughts on our pain, how we shouldn't be having it, how negative it is, how horrible, then we devote a lot more of our attention and our neural pathways to this production of more pain.

 

The last way that our brain produces more pain for our body is by camisa phobia, which is the fear of moving for fear it will produce pain. I felt this before when I had knee pain for a couple of months. And I went to a yoga class. I was sitting and watching the instructor. And when she did a move, I literally felt pain in my knee because my brain was thinking if I did that move, it would cause pain in my knee. So I felt it beforehand. It was my brain’s way of trying to prevent any further harm. Usually with people who have chronic pain, they have a list of things they cannot do and it grows more and more as they realize any things that can cause them pain, and their brain tends to amplify that situation, and the avoidance of pain and the avoidance of movement. 

 

So it's easy to say with all of this misinformation about chronic pain, what it is the confusion with nociception. Doctors telling you there's something physically wrong with your body, or that they can't find anything wrong with your body. Plus the fact that we know that the more the brain focuses on pain and avoidance of activities, it causes the pain to actually grow. There can be a spiral effect as people stopped doing as many movements maybe stopped doing activities that they enjoy or interacting with people as much on a social level. And when you're so focused on preventing the pain, you start avoiding some of the good things that you naturally like to do that would provide the body's natural endorphins endorphins are created as The natural feel good chemical of the body. But if you're not participating in things you enjoy, not only are you focusing and growing your pain, but you're not providing the natural painkillers that are available to you from your brain. And as a result, the pain becomes more and more disabling. 

 

Having fear, or worry or stress can cause increased pain in the body. So how do we decrease that pain? Well, fortunately, our brain is plastic. We can change this process by focusing on more positive thoughts and feelings. If you can start to fill your life with more positive activities, then when you engage in those activities, not only does your brain suppress the pain, but the pain becomes less important to you, because you're doing things that you value or things that have meaning for you. This basically turns down the pain when you engage in positive activities. So when you fear and avoid the pain, you increase the pain response. But when you engage in positive activities, thoughts or feelings, you can turn down the pain response. Chronic pain is an epidemic of fear. That's how it is perpetuated. 

 

And remember how low those vibrations of fear are on the map of consciousness? We want to increase our vibrations to higher emotions so we can rest and repair. Even courage or acceptance has a much higher vibration than fear and can help your body get to that healing state. Gratitude is an emotion that ranks about 900 hertz, so it's a very high-frequency emotion. That's because when you're in the emotional state of gratitude, there's no scarcity. You're just grateful for what you already have. So if you are really wishing that your life was different, and you are upset that this is happening to you, and you can't wait for things to change until you get out of pain, then it's impossible to feel gratitude. But looking on purpose for things to be grateful for, and cultivating as great of a sense of gratitude as you can, under your current conditions, is one of the best ways to actually change your condition. If you can think thoughts that genuinely give you the emotion of gratitude, if you can shift your focus to things that bring you joy, and if you can do things in life that have value to you, you will increase your natural endorphins and decrease this programmed response, this hyper-reactive response, to pain.

 

Now the last, but very important, piece to healing is to have patience and compassion for yourself. Just like if you listen to some of my other podcasts, you might have learned that we are able to control our emotions despite what is going on in the outside circumstances of the world. But just like emotional regulation sounds really nice in theory, it can be actually very hard to do. You might get frustrated with yourself if you do end up getting angry and yelling at your kids because you know, you should know, better. The same type of thing can happen with pain. Be curious, not judgmental, replace criticism with compassion. And try to be open to what your body is telling you and teaching you rather than being resistant to the pain. 

 

If you have questions about applying this in your life, sign up for a one-on-one coaching call with me. My website, bodyandmindlifecoach.com, should be up in a couple of weeks. But until then you can email me at info@bodyandmindlifecoach.com.

 

Thank you so much for listening. I hope you learned a little bit about your brain today that helps you in your life like it helped me. Please be sure and subscribe and leave a review. And, of course, be sure and share this podcast with someone you know who wants an unstoppable body and mind.