Use It, or Lose It: Using the Brain to Conquer Chronic Pain Syndrome

In one of my favorite episodes of the TV show “The Office” Jim, the office prankster, messes with his desk partner, Dwight. In the episode, Jim secretly trains Dwight to crave Altoids whenever he hears the music associated with a computer being turned off. Jim continues this experiment until finally Dwight is left with a confusing need for an Altoid every time that well known Microsoft log off music is played even when a mint is not offered—leaving a bad taste in Dwight’s mouth, literally. So, what’s the significance of this anecdote about the psychological battle between two co-workers? This mind tricking prank, inspired by physiologist, Ivan Pavlov’s work, does a great job of explaining how our brains can perpetuate chronic pain even after the initial injury is “healed.”

Our brains are incredible things. From the time we are babies, the brain is developing pathways to allow us to roll over, sit up, crawl, walk, and even write our names. Practice is required to master each movement we make, no matter how small and simple it seems. Each time a movement is repeated, the details of how to carry out that particular activity, are etched deeper into the mind. Each pathway is like a hiking trail. The first time you go on a hike through the woods, you have to create your own path—dodge rocks, knock down grasses, and maneuver through obstacles. But, if you hike this same route again and again, you slowly start to wear down the earth and create a path to follow. This is how our brain works when we are learning new skills.

When a young child is learning to write his name, the letters start out large and rough around the edges. Let’s face it, compliments on penmanship are not heard the first time out of the gate. But, as time goes by and this child writes his name more and more, finesse and control become second nature—the brain creates a well-worn pathway that follows the most efficient directions to accomplish the desired task. The brain seems to be a well-oiled machine, right? What if there is an interruption or break down in the form of an injury? What kinds of road blocks can arise following injury?

The first thing we usually associate with an injury is pain. Pain can cause an injured person to be sidelined from a lot of their activities. After an injury, it is natural to want to move more gingerly to guard and protect yourself from further pain. The pain signals us to take it easy, rest the injury, and the eventual absence of pain helps us to know when we are healed and ready to move back to regular activities. There are, however, other outcomes that cause pain to become a more debilitating problem which mentally makes it more difficult to achieve recovery.

One option that is sometimes unknowingly chosen is the route to Chronic Pain Syndrome. As mentioned above, following an injury it is natural to limp or change movement patterns to protect the vulnerable area. But, when this guarding makes us afraid to move, we risk the outcome of having a loss of coordination and ultimately increasing our sense of chronic pain long after the injured tissue is healed and no longer needs to send pain signals to the brain. This path tends to spiral and grow in magnitude until inaccuracies to the movement pathways in the brain put us at risk for re-injury.

The second option when coming to the fork in the road of recovery is a track towards rehabilitation. This encompasses slow and mindful functional movement exercises to rebuild and reinforce good movement pathways. The goal is to maximize control over muscle groups and joints in a safe and effective way. Side benefits of this route include decreased pain, improved sports performance, and reduced risk of re-injury.

So, what’s the recipe for retraining the brain after an injury and improving stability? Let’s break it down:

1. MOVE. As humans we are made to move. Well thought out and slowly progressive exercises help to retrain the brain as much as strengthen your body. But moving is not synonymous with speed. Moving through exercises thoughtfully and slowly while focusing on what you are trying to accomplish allows the edited movement patterns to be imprinted on the brain.

2. TIME. Rome wasn’t built in a day. It takes time to reach a level of mastery. It was mentioned earlier that when learning to write your name as a child, you didn’t have the same control and speed of the pen that you do today. As you move more and practice repetition of those functional movements, the brain and body will learn to coordinate and work better together.

3. QUALITY VS. QUANTITY. Rushing through an exercise program to reach the end goal, or pushing through the sets and reps with poor form to hit a new personal record, are recipes for disaster. When quality of movement is pushed to the wings to make room for increased quantity, you put yourself at risk for ingraining poor movement patterns into the brain’s ever changing pathways. Once bad habits are taught, they are challenging to undo. Sometimes, less is more.

Not only does the body need us to move to stay healthy, but our brains need us to move in order to keep pathways open and maintain our well-oiled mental machine. But, we live in a 21st century world where sitting occupies most of the day for a lot of people. We sit at work, in the car, in front of the TV or gaming system, at kids’ soccer practices, and so on. Our brains are constantly changing and editing these movement pathways, and without exercise and good functional movement patterns, the brain can’t maintain the pathways to help us stay coordinated and functioning at our prime. So, I hope you’ll take advantage of the time you have to move strategically and thoughtfully to help you maintain maximum coordination and balance, and minimize chronic pain.

Until Next Time,

Abby Scheer, DC