For years neuro-scientists have known that Chronic Pain can cause brain atrophy (shrinkage) that is indistinguishable from Alzheimer’s Disease or Dementia. More recently The Journal of Neuroscience reported that
“The longer the individual has had Fibromyalgia, the greater the gray matter loss, with each year of fibromyalgia being equivalent to 9.5 times the loss in normal aging.” McGill University Centre for Research
Think about this for a moment. Every single year you live with Fibromyalgia (or other Chronic Pain Syndromes) is the equivalent of nearly 10 times the brain loss seen in the normal aging process. Re-read this paragraph until the urgency of your situation sinks in!
Although there are several types of pain, and Chronic Pain can get extremely complex; we are going to try and keep this simple. For our purposes, there are two types of Chronic Pain. It has to do with where the pain comes from. Chronic Pain originates in one of the two following areas
- Central Nervous System
- The Body
As we will discuss shortly, pain that arises in the CNS is frequently “learned” pain. In order to learn how to hit a golf ball, speak Swahili, or play the Dobro, you have to practice. We all remember the old adage; Practice makes Perfect. Unfortunately, that is how it tends to work when it comes to pain.
If you stimulate pain pathways in the Brain & Nerve System long enough, or are exposed to enough stressors in your life (chemical, emotional, dietary, physical, bacterial, viral, parasitic, electro-magnetic, etc), you can alter the way your Brain and Central Nervous System function. This is an extremely complex scenario that is going to require special treatment as well as time to heal. It also requires a unique approach. Because the pain is pathologically locked into the CNS, the method of removing it must specifically target the CNS, as well as the metabolic causes of the pain. This type of Chronic Pain will requires require some sort of Brain-Based Therapy.
However, pathological pain syndromes that arise from a malfunctioning CNS are not the chief thrust of this website. Nor is it my belief that they are the most common cause of Chronic Pain. Although we will spend some time now and then discussing CNS-based pain, this website is specifically devoted to Chronic Pain that is not “locked” into the Brain.
“Simple Nociception” is the simplest type of pain. If someone steps on your toe, it hurts. This is normal, and means that your nervous system is functioning properly. Get the person off your toe, and the pain goes away —- almost immediately. Simple. There are several different types of “Nociceptive Pain,” but the one that we are most concerned about on this website is the one that has to do with “deep” musculoskeletal pain, otherwise known as Deep Somatic Pain (Greek “Soma” = body).
Deep Somatic Pain is pain that originates in tissues that are considered to be “deep” in the body. Although we do not always think of many of these tissue types as being “deep”, this category includes things like ligaments, tendons, muscles, fascia, blood vessels, and bones. Remember this, as it will be very important later on. Back to nociception. There are two main types of Nociceptors
The Chemical Nociceptors are stimulated by noxious chemicals, the chief of these being something called “inflammation“. Inflammation is probably not what you thought it was. Inflammation is the collective name for a group of chemicals manufactured by your body’s Immune System. They have names like prostaglandins, leukotrienes, histamines, cytokines, kinins, etc, etc, etc). Although inflammation is at the root of most health problems here in America (Diabetes, Cancer, Fibromyalgia, Endocrine Problems, Thyroid Problems, Arthritis, Heart Disease, and numerous others are all considered to be “Chronic Inflammatory Degenerative Diseases“), you will soon see that “Local Inflammation” (swelling, redness, etc) sometimes gets more credit than it deserves — particularly when it comes to tissues of the Deep Soma.
You must also be aware that exposing microscopic scar tissue to chronic inflammation can potentially hyper-sensitize the nerves within said tissue. This ‘hypersensitization’ can make the affected nerve tissue up to 1,000 times more pain-sensitive than normal tissue. Gulp! Increased tissue acidity (usually caused by hypoxia — “diminished tissue oxygen levels“) is another common form of Chemical Nociception, and most commonly occurs as the result of a junky diet. However, it can also be caused by relentless Mechanical / Neurological / Immune System Dysfunction as well.
As you might imagine, Mechanical Dysfunction stimulates the Mechanical Nociceptors. This group of nociceptors is stimulated by constant mechanical stress. Stretch, tension, mechanical deformation, pressure, etc are the things that cause Mechanical Nociception, which, can in turn cause pain. In the case of Mechanical Nociception, remove the offending mechanical stressor, and you remove the pain. Sounds simple, doesn’t it? It is — sometimes. Unfortunately, nothing is ever quite as simple as it appears.
Be aware that even Simple Nociceptive Pain can actually become Brain-Based over time. This is called “Supersensitivity” and is caused by alterations in the Brain and Central Nervous System that perpetuate the pain cycle. Even though the injured tissue has, according to all of the medical tests, “healed“, it has healed improperly; i.e. microscopic scar tissue. Although this frequently causes the Deep Somatic Pain that this website is all about, these tissues can actually become Hyper-sensitized. I probably do not need to tell you that this is really really bad news!
As nerve function and proprioception become increasingly fouled up (more on proprioception shortly), degenerative arthritis and joint deterioration begin to set in. Because of involvement in the Brain or Central Nervous System, this pain is often referred to as “Neuropathic Pain” or “Neruogenic Pain”.
Sometimes people end up with HYPERALGIA (Stimulus that should cause a little pain, causes extraordinary amounts of pain) or ALLODYNIA (Stimulus which do not normally elicit any pain at all, now cause pain). Sometimes these two overlap. Stay with me and you will begin to understand why.
MICROSCOPIC SCAR TISSUE
As we learned a moment ago, scar tissue (yes, even the microscopic kind we will talk about at length shortly) can become hyper-sensitized. Recent scientific research shows that due to increased nerve conductivity and diminished ability to receive oxygen (hypoxia), as well as subsequent tissue acidity and constant mechanical pressure and deformation (we call this restriction); scar tissue can become up to 1,000 times more pain-sensitive than normal tissue! Did you catch that? Re-read this paragraph again and let the magnitude of what it is saying sink in.
HYPER-SENSITIZED NERVES & THEIR RELATIONSHIP TO INJURED OR DAMAGED CONNECTIVE TISSUES
Think of nerve endings as the twigs at the very end of a tree limb. Nerves (just like a tree) begin with a large trunk, which forks into smaller and smaller branches until eventually you arrive at the tiny twig (or nerve ending) at the end of the very smallest branches.
If you have ever seen a “topped” tree, you can understand what happens to nerve endings that are found in microscopic scar tissue. Professional Tree Trimmers cut (or “top“) the largest branches just above where the trunk splits into two or three limbs. What happens to these stubs? Instead of having limbs that continue to branch out and divide into ever-smaller limbs in a normal fashion, you get a stub or stump, that in a short matter of time, swells up and has hundreds of tiny twig-like limbs growing from it. “Topping” stimulates the growth of twigs from the stump. The injured nerves found in microscopic scar tissue act in much the same way.
As the larger nerves that are found in soft tissues are injured, you end up with an inordinate number of immature nerve endings (twigs) growing out of an inflamed nerve “stump”. As you might imagine, extra pain receptors are never a good thing! As I said a moment ago; the latest research is saying that the nerve endings found in scar tissue and microscopic adhesion can become hyper-sensitized up to 1,000 times. Unfortunately, as you’ll see on the next page, this is just the beginning.
As you should be starting to realize, scar tissue (even the microscopic kind) is bad —- very bad. An exceedingly common cause of Chronic Pain is the microscopic scarring and adhesion so characteristic of injuries or overuse / abuse to the Elastic, Collagen-Based Connective tissues of the “Deep Soma” — particularly fascia. Please do yourself a favor. If you have Chronic Pain that might be arising from the tissues of the Deep Soma, please read the next page. It is here that you will learn about one of the chief causes of Chronic, Deep Somatic Pain — Fascial Adhesions.