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How to use Neuroplasticity to Decrease Chronic Pain

What is Neuroplasticity?

Neuro refers to the nervous system (brain, spinal cord, and nerves) and plasticity is the ability to change. So the simplest definition of neuroplasticity is the nervous system’s ability to change. We all have this ability, but it is well-known that our ability to mold and create new connections in the brain is greatest as a baby and diminishes throughout life. But please do not get discouraged. We can tap into our body’s plasticity at any age and even learn how to enhance our own ability to keep adapting our brain.

Why Neuroplasticity is Both Good and Bad:

Why do you want to change your brain? It is important for our brains to learn and unlearn – especially when you get into a rut such as a negative thinking pattern, habit, or get caught in a chronic pain cycle.

Neuroplasticity allows us to do the following:

  • Learn new things – a language, how to play a game, learn a new task

  • Improve coordination and efficiency of tasks

  • Recover from an injury to your brain (from a stroke, traumatic brain injury, or other insult)

  • Improve relationships and outlook on life

  • Recover from chronic pain, depression, anxiety, and dizziness

Neuroplasticity is what allows you to learn to ride a bike. But it also contributes to chronic pain and negative thought patterns. People who struggle with long-term pain once the original cause is no longer present can thank neuroplasticity for subconsciously training their nervous system to be hypersensitive to movements and sensations that normally would not cause such an intense response. If you think of your brain as a control room, imagine someone coming in and turning your pain sensitivity dial from a 3 to a 10. Unfortunately, over time you do not become desensitized to stimulus and pain. Instead, people tend to become more and more sensitive. It seems like almost anything can set you off – getting sick, emotional stressors, normally benign movements. Sometimes even thinking about doing a movement that normally would cause you pain can trigger a pain flare up.

One theory behind why this happens is that our bodies create this response for survival. If you broke your leg, for example, your body wants to protect you from doing that again because a broken leg means you cannot forage for food and cannot run from a predator. So to make sure you are more careful moving forward, your nervous system decides to send you a constant or periodic painful reminder. Despite the scars healing and imaging showing everything has healed, you still feel pain. This hypersensitivity response of the nervous system is called Central Sensitization.

The good news is you can tap into the same phenomenon that has caused chronic pain to get out of the vicious cycle.

How to use Neuroplasticity to Improve Pain:

  1. Educate yourself. Understanding how and why your nervous system is responding in an abnormal way is informative in identifying and correcting contributing factors. This includes understanding central nervous system sensitization as well as psychological, social, and environmental factors that may be contributing to your pain.

  2. Try novel tasks. Learn a new language, travel, or get into the state of flow by creating music, art, or writing.

  3. Play. Change the way you move your body. When we experience something as enjoyable and fun versus a tedious task, we tend to experience less pain while doing it.

  4. Change the way you think about a sensation. Work on diminishing catastrophic thinking about pain and developing more active coping strategies.

  5. Practice mindfulness. A simple-sounding, but sometimes difficult practice of keeping your mind in the present and not fixated on past or future events allows us to start to break out of fear-tension cycles and start to disassociate from expectations of old action – reactions.

  6. Manage stress. Yoga, Tai chi, breathwork and journaling are all healthy responses to stress. Identifying and altering stressors such as unhealthy jobs and relationships are difficult, but key factors to address. It is also vital to learn to identify and manage stressors beyond your control (such as pain) in order to help get you out of the pain cycle.

  7. Exercise. Exercise is an overall brain-booster and is a great way to improve your neuroplasticity. This is why studies show that exercising alone can decrease cognitive decline. When experiencing chronic pain, it is very important to slowly add in graded exercise to make sure you avoid an unwanted response from your nervous system.

  8. Improve your overall health. Optimize your sleep and diet, stay hydrated, spend more time in nature, remove toxins, and practice good hygiene. There is evidence that the immune system plays a part in why some people’s central nervous system becomes more sensitive than others. Anecdotally, many people have claimed healing from chronic inflammation and infection was a part of breaking out of their chronic pain cycle.

  9. Dry needling. Dry needling has been shown to be helpful in rewiring the brain. Studies show that it decreases the excitability of the central nervous system, decreasing the activation of pain-associated areas in the brain. It also helps modulate central pain at the spinal cord level and through a complex cascade of chemical inhibitions and activations.

How Physical Therapy Promotes Neuroplasticity

Combining a Top-Down and Bottom-Up Approach: Chronic pain isn’t always just “in your head.” There may also be peripheral factors feeding into the pain cycle. Working on rewiring your brain while decreasing the pain at the source can be the one-two combo needed to move past your chronic pain. Some techniques physical therapists use include massage, myofascial release, dry needling, hot/cold therapy, electrical stimulation, stretching, strengthening, and improving posture and movement patterns.

Habituation: A big part of chronic pain is fear of movement. Unfortunately, fear itself can feed into muscle tension which leads to pain and continues the vicious cycle. Habituation is a technique used in physical therapy to safely introduce a movement or stimulus. It starts small and is graded as tolerated to teach the brain that the movement is safe, to give the body time to adapt and learn, and to avoid an overreaction from the nervous system.

Adaption and Application: The next step is teaching you to apply graded and controlled movement patterns to life situations outside of “therapeutic exercise.” Our bodies are complex. We move with many degrees of freedom. Physical therapy can help bridge the gap from learning to isolate a single movement without pain to translating it to pain-free biking, mowing the lawn, and playing with your kids.

Struggling with chronic pain? Contact House of Balance Integrative Health and PT to learn more about what we do and how we can help you get out of pain and living your best life.



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