Having lived with back pain, I found this fascinating.

[dorminWS]

Today's selection -- from The Brain's Way of Healing by Norman Doidge. It is the brain, not the body, that experiences pain. Repeated trauma can cause the brain to experience more pain than is warranted, a phenomenon referred to as chronic pain. This gives hope that chronic pain can be remedied through treatment of the brain:

"Touch a part of the body's surface, and a specific part of the brain map, devoted to that spot, will start to fire. These maps for the body's surface are organized topographically, meaning that areas that are adjacent on the body are generally adjacent on the map. When the neurons in our pain maps get damaged, they fire incessant false alarms, making us believe the problem is in our body when it is mostly in our brain. Long after the body has healed, the pain system is still firing. The acute pain has developed an afterlife: it becomes chronic pain.

"To understand how chronic pain develops, it's helpful to know about the structure of neurons. Each neuron has three parts: the dendrites, the cell body, and the axon. The dendrites are treelike branches that receive input from other neurons. The dendrites lead into the cell body, which sustains the life of the cell and contains its DNA. Finally, the axon is a living cable of varying lengths (from microscopic ones in the brain to others that run down to the legs and can be three feet long). Axons are often compared to wires because they carry electrical impulses at very high speeds (from 2 to 200 miles per hour) toward the dendrites of neighboring neurons. A neuron can receive two kinds of signals: ones that excite it (excitatory signals) and ones that inhibit it (inhibitory signals). When a neuron receives enough excitatory signals, it will fire off its own signal. When it receives enough inhibitory signals, it becomes less likely to fire.



Electrodes placed on the surface of the cortex can be used to stimulate the brain of a conscious patient or record its activity. Photograph: Eric C. Leuthardt

"Axons don't quite touch the neighboring dendrites. They are separated by a microscopic space called a synapse. Once an electrical signal gets to the end of the axon, it triggers the release of a chemical messenger, called a neurotransmitter, into the synapse. The chemical messenger floats over to the dendrite of the adjacent neuron, exciting or inhibiting it. When we say that neurons 'rewire' themselves, we mean that alterations occur at the synapse, strengthening and increasing, or weakening and decreasing, the number of connections between the neurons.

"One of the core laws of neuroplasticity is that neurons that fire together wire together, meaning that repeated mental experience leads to structural changes in the brain neurons that process that experience, making the synaptic connections between those neurons stronger. In practical terms, when a person learns something new, different groups of neurons get wired together. As a child learns the alphabet, the visual shape of the letter A is connected with the sound 'ay.' Each time the child looks at the letter and repeats the sound, the neurons involved 'fire together' at the same time, and then 'wire together'; the synaptic connections between them are strengthened. Whenever any activity that links neurons is repeated, those neurons fire faster, stronger, sharper signals together, and the circuit gets more efficient and better at helping to perform the skill.

"The converse is also true. When a person stops performing an activity for an extended period, those connections are weakened, and over time many are lost. This is an example of a more general principle of plasticity: that it is a use-it-or-lose-it phenomenon. Thousands of experiments have now demonstrated this fact. Often the neurons that were involved in the skill will be taken over and used for other mental tasks that are now being performed more regularly. Sometimes one can manipulate the use-it-or-lose-it principle to undo brain connections that are not helpful, because neurons that fire apart wire apart. Suppose a person has formed a bad habit of eating whenever he is emotionally upset, associating the pleasure of food with the dulling of emotional pain; breaking the habit will require learning to disassociate the two. He might have to actively forbid himself from going to the kitchen when he is emotionally upset, until he finds a better way to handle his emotions.

"Plasticity can be a blessing when the ongoing sensory input we receive is pleasurable, for it allows us to develop a brain that is better able to perceive and to savor pleasant sensations; but that same plasticity can be a curse when the sensory system that is receiving ongoing input is the pain system. That can happen when a person slips a disc, which then presses repeatedly on a nerve root in her spine. Her pain map for the area becomes hypersensitive, and she begins to feel pain not only when the disc hits the nerve when she moves the wrong way, but even when the disc is not pressing hard. The pain signal reverberates throughout her brain, so that pain persists even after its original stimulus has stopped. ...

"[Researchers Patrick David] Wall and [Ronald] Melzack showed how a chronic injury not only makes the cells in the pain system fire more easily but can also cause our pain maps to enlarge their 'receptive field' (the area of the body's surface that they map for), so that we begin to feel pain over a larger area of our body's surface. ...

"Wall and Melzack also showed that as maps enlarge, pain signals in one map can 'spill' into adjacent pain maps. Then we may develop referred pain, when we are hurt in one body part but feel the pain in another, some distance away. Ultimately, the brain maps for pain begin to fire so easily that the person ends up in excruciating, unremitting pain, felt over a large area of the body -- all in response to the smallest stimulation of a nerve.

"Thus, the more often [a person feels] twinges of neck pain, the more easily his brain's neurons recognized it, and the more intense it got. The name for this well-documented neuroplastic process is wind-up pain, because the more the receptors in the pain system fire, the more sensitive they become.

"[One patient we were studying] realized that he was developing a chronic pain syndrome and was caught in a vicious cycle, a brain trap: each time he had an attack of pain, his plastic brain got more sensitive to it, making it worse, setting him up for a new, still worse attack next time. The intensity of his pain signal, the length of time it lasted, and the amount of space in the body it 'occupied' all increased."



The Brain's Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity
Author: Norman Doidge
Viking published by the Penguin Group
Copyright 2015 by Norman Doidge
Pages 7-9

[kelu]

And what does it say about healing the brain?

[dorminWS]

And what does it say about healing the brain?

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You see, it's all in your head.

Interesting because, among other reasons, it at least implies that if your brain can con you into hurting when you really don't, it can also talk you into NOT hurting when you really do. It does, at any rate, seem to lend some credence to my longstanding assertion that pain is largely subjective and therefore what you allow it to be; at least with the bounds of human tolerance.

[thekinetic]

Interesting but I still must insist my back still hurts like @#%$!

[Maverick]

"It is the brain, not the body, that experiences pain"

Yea sure, tell that to my body..It will dissagree for sure.

[Mindflayer]

dorminWS, there's been a lot of research into neuroplasticity - some of it genuine science, some of it junk science pushed by Scientologists. I always take the stuff with a grain of salt, especially when it comes to back pain.

Harvard Medical, JH, and a few others have done very recent set of studies that showed pain in the lower back actually disrupts the brain - negatively affecting the very plasticity on which Doidge writes.

All I know is Dr Melisi f*** up my back and I have never been right since.

[dorminWS]

dorminWS, there's been a lot of research into neuroplasticity - some of it genuine science, some of it junk science pushed by Scientologists. I always take the stuff with a grain of salt, especially when it comes to back pain.

Harvard Medical, JH, and a few others have done very recent set of studies that showed pain in the lower back actually disrupts the brain - negatively affecting the very plasticity on which Doidge writes.

All I know is Dr Melisi f*** up my back and I have never been right since.

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I have found that I can usually mitigate (but not eliminate) my back pain by focusing on something else and in effect ignoring not the pain but the severity of it. I had a sister who had also had back surgery and used to sit around talking constantly about how badly her back hurt. I told her to try to put it out of her mind and think about something else and she called me a cruel heartless bastard who didn't care that she was hurting. I was truly trying to help her, but she just couldn't believe what I had told her wasn't a cruel joke. We were both sincere, but our perceptions were just widely divergent. I'm sorry to say she wound up addicted to painkillers and eventually overdosed.

Past a certain point, of course, this "willing away" pain doesn't work; and I have to resort to painkillers. I resist this because taking painkillers and muscle relaxers makes me sick and miserable. But when it gets that bad, it's time to check in the hospital anyway. I've had most of the doctors who have treated me tell me I have a high pain threshold. But I don't know whether I have the high threshold because I try to "will away" the pain or whether I try to "will away" the pain because I have a high threshold. Anyway, I am firmly convinced, based upon my own experience, that pain can be significantly influenced (positively AND negatively) by the mind and the will. Perhaps part of my attitude on this is borne of the fact that I grew up at a time and in a place where you were expected to be pretty stoic and most people just didn't go to a doctor unless and until they were in pretty bad shape. They used to rely on moonshine for pain relief around here; now it's Oxys, Roxies, and (I forget the other one).

[SHMIV]

I won't say that I "will " pain away, but I surely ignore it away fairly regularly. I have an aversion to pills, or putting any chemical substance into my body, for that matter. I keep a bottle of Aleve on the truck, but I rarely utilize it.

I, too, am of the "man up, stop whining, and don't talk about your afflictions" school. The last two times I saw a doctor was for that damned physical that the law requires, so that I can continue to drive a truck for a living. I hate those.

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[OakRidgeStars]

I, too, am of the "man up, stop whining, and don't talk about your afflictions" school. The last two times I saw a doctor was for that damned physical that the law requires, so that I can continue to drive a truck for a living. I hate those.

Dr Ben Dover will see you now.

[Mindflayer]

I agree - I am not going to let my pain define my life. People sometimes say, "Hey, 'Flayer, you have handicap plates but yet you go hunting and hiking and stay pretty active. What's up with that?" I tell them exactly that - I am not going to let my constant pain drag me down. Military father and a Japanese mother - you better man up and press on.

That said, man oh man, I had a surge so bad about an hour ago it brought tears to my eyes. I find the best medicine is bourbon, but I am trying to lose a few pounds, so no booze and sucking it up tonight!

[Maverick]

I agree - I am not going to let my pain define my life. People sometimes say, "Hey, 'Flayer, you have handicap plates but yet you go hunting and hiking and stay pretty active. What's up with that?" I tell them exactly that - I am not going to let my constant pain drag me down. Military father and a Japanese mother - you better man up and press on.

That said, man oh man, I had a surge so bad about an hour ago it brought tears to my eyes. I find the best medicine is bourbon, but I am trying to lose a few pounds, so no booze and sucking it up tonight!

Good luck with your adventures...Hope it gets better for you.

[dorminWS]

I find the best medicine is bourbon, ........................

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My preferred quasi-medicinal libation is single-malt scotch, but to each his own. Many's the time I have told both my doctor and SWMBO not to worry; that alcohol is nature's muscle relaxer.

[SHMIV]

Ahh, single malt scotch. I recently celebrated a birthday , and W2B gave me a bottle.

I found that it paired well with a Cohiba.

Hard to feel pain with a genuine smile on your face.

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[dorminWS]

Yup. As long as they keep making stuff like Macallan 18 and Glenfiddich 18 they can keep their danged old Flexeril.

[Mindflayer]

I like Macallan 18, but my absolute preferred is Bushmills 16. I'll take a whiskey over whisky any day!

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[dorminWS]

I like Macallan 18, but my absolute preferred is Bushmills 16. I'll take a whiskey over whisky any day!

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I wouldn't turn my nose up at Bushmills 16. The Scots and the Irish are closer kin than either of them will admit, and they both know how to make whiskey/whisky.

[Reverenddel]

Love how the conversations taper from "pain" to "Fine alcohols"

Which indeed ARE more "natural" than prescriptions, and probably do LESS damages.

Those of you with severe pain, and such have my sympathies. I have "Gettin' Old" pains, but nothing that keeps me from doing anything. When those pains start up? I like bourbon.

I have a few I prefer, right now? The Bowen-Smith Distillery is rocking my world. They have some fine stuff out there. Along with Buffalo Trace, and Bullet.

[mamabearCali]

I go with a girly peach schnapps.

I have a fairly low level of constant discomfort in my ankles and back. Comes of some repeated falls that put my ankle in a constant state of sprain and some scoliosis that was quiet until I was 31 and decided to shovel some snow.

As long as it stays at a low level I ignore it. When it begins to creep up I take note pay attention and try to calm it down.

What stinks worse than back pain is the ankle. I fall all the time. Even with ankle strengthening exercises I still fall. I am walking down the road doing nothing really and suddenly I am on the ground and have to use a cane for a week to get around. I am 34 now.......sigh.

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