Understanding Pain-Part 2

In my previous blog ‘Understanding Pain’, I briefly mentioned the connection between psychological stress and muscle tension.  I did not diverge down that path because the blog was focused on symptoms brought about by prolonged muscle tension. But a discussion of pain without looking at the psychological portion is hardly complete.

So let’s start with simple stress:  You hear a lion roar, and your brain reacts quickly.  Not your conscious mind but the limbic system.  This deeper part of the brain is where: short term memories are converted to long term(in the hippocampus), trauma is recorded for later recall(in the amygdala), the master control of your hormonal system resides(the hypothalamus and pituitary gland). Hormones are released to get the adrenal glands acting. Blood vessels constrict and decrease the blood supply to your skin and digestive tract to make it available to your muscles and brain. Blood pressure and heart rate go up and your immune system is suppressed. All energy goes toward surviving. If you sprain your ankle while fighting or running away, swelling won’t be noticed because healing tissue is not important now. If you survive, you can heal injuries and digest food later.  This system is built to run briefly and shut off.  When the danger is over, systems go back to normal.  But when chronic stress is involved, these reactions don’t return to normal.  Any or all of these systems can break down and send you to a specialist. Keep that blood pressure up and your cardiologist will see the damage done.  Limit the blood supply to the stomach and you won’t get the mucus coating that protects the stomach from the strong acid it must contain. So you see the gastroenterologist for ulcers. Don’t give the skin proper circulation and you are seeing the dermatologist.  Suppress the immune system, you get sick more. Then there are the muscle issues described before. 

These are the pitfalls of living with persistent stress, but the pain story runs deeper than that.  Just as a sound can initiate such a massive response, so can a smell or a memory.  Remember; past traumas have been recorded in the part of the limbic system called the amygdala. It is like the black box that records everything that happens on a plane flight. But in a human, emotional trauma and pain get recorded in that black box.  Have you ever wondered how an amputee can have phantom limb pain?  Pain can’t originate in a non-existent limb.  But it can in that black box we call the amygdala.  A signal starting there(for whatever reason) that reaches the outer surface of the brain where sensations such as itching or aching or sharp pain are mapped, will be felt just as if that signal had started in a limb.

No signals starting from below(in a limb for example) can be mapped as sensations without connecting with the limbic system along the way. But signals can start IN the limbic system without coming from below. So stress and previous physical and emotional trauma are always possible contributors to pain symptoms. A signal can start below but then get amplified or diminished in this deeper part of the brain as with a volume control on your stereo.  

For some pain sufferers, learning to recognize their feelings and memories that trigger symptoms is the major key to stopping their pain. Others, need physical treatment of guarding muscles and joints while also addressing the psychological stressors that add to the mix. In the first blog, I mentioned that resolving pain required addressing the source.  That means what starts below the limbic system(somatic and viscero-somatic) and what starts in and around the limbic system(psycho-somatic). 

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