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From Nerves to Neurons: Decoding the Connection Between Pain and Brain Function

Updated: Jun 28

The Pain-Brain Relationship

I was recently asked if chiropractic care can help with psychological health.

What a sticky subject to get into.

As someone who has dealt with psychological health issues at different times in my life, I know that there is a special relationship between the physical pain we feel, the emotional/psychological concerns, and how that relationship can create a cyclical experience that seems to feed into itself in a way that decreases overall health and well-being.

Research shows us that our physical sensations can be directly effected by our psychological state. For example, studies show a higher prevalence of chronic health and pain conditions in individuals who experience significant trauma. In the book “The Body Keeps the Score”, by Bessel Van Der Kolk, the author speaks of the relationship between trauma and the disconnection between the frontal lobe (executive function) and the limbic system (emotional function). In his opinion, the best way to re-engage the relationship between these two parts of the brain is through movement and bodily engagement. We have to activate the part of the brain that sees and processes bodily sensations in order to have the cooperative relationship between emotion and (emotional) regulation.

There is research out there that shows a relationship between joint manipulation and the area of the brain called the pre-frontal cortex. This area houses the somato-sensory cortex, which is the area that senses the body. Other body-work practices like massage and acupuncture may have similar results in activating this area of the brain. This is the area of the brain that Van Der Kolk claims needs to be actiated for the re-connection process to happen between the limbic and frontal lobe.

One of the things I talk often about is something called the default mode network. This is an exceptionally interesting network within our brains that is actively engaged when our brain isnt. The default mode network (DMN) is active when we are “day-dreaming”, for example. It is active when we are not actively engaged in a task, so when we are sitting and “doing nothing”. The DMN is implicated in a number of perceptual activities, such as thinking about others and remembering the past or thinking about the future. It may even be the neurological basis for the sense of self.

When someone has a chronic pain issue, there is a measurable change in how the default mode network functions. Meaning that when someone is dealing with pain, their pain literally effects their brain, and how their brain functions in relation to their perception of themselves and the world around them. How many of us have been dealing with a pain flare-up, and found ourselves feeling and acting more on-edge or "grumpy"?

A study from 2020 in Frontiers in Integrative Neuroscience assessed the functional MRI of subjects who had chronic pain and underwent a trial of spinal manipulation therapy (SMT). There were 2 groups of subjects, one which received SMT, and one that did not. The group that received only 6 sessions of SMT had significantly more activity in the DMN than baseline. They also reported lower pain levels.

So back to the main question: can chiropractic spinal manipulation help with psychological health issues?

Most people I have met have some pain or discomfort issue that they have noticed for more than a few months, either consistently or off-and-on, making it a chronic pain issue. If they have had chronic pain, especially if it has interfered with how they are able to conduct their life, then they likely have a risk of their DMN being affected. If this person also deals with depression or anxiety issues, it may be possible that by changing the way the body feels and functions, we can have a change in the way the brain feels and functions.

It must be said, however, that chiropractic care may be a beneficial adjunctive treatment for someone who is receiving proper treatment by a trained and licensed psychological health provider. The chiropractor IS NOT the one providing care for the psychological health issue, but is the one providing primary musculoskeletal health care. Treatment of individuals who have both psychological and musculoskeletal health concerns should be a co-management and a cooperative treatment situation.

This blog is not meant to diagnose, treat, or give specific recommendations for any psychological health concern or issue. If you would like more information or resources to address your psychological health concerns, please visit Bay Area Psychological Association resource page. You can also reach the Substance Abuse and Mental Health Association hotline at  1-800-662-HELP (4357).

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