Substance-P: The “P” in Pain
(Workbook: Page 36)
Substance-P is the main pain neurotransmitter. It has five basic functions in the body. They are pain, inflammation, anxiety, depression and nausea. Even though these seem like negative experiences, they are important for survival. Problems arise with excessive production and release of Substance-P. Look at the graphic on page 36 of the Neuroplastic Transformation workbook. It depicts a nerve injury causing a massive release of Substance-P, up to 5 times greater than in acute pain. This diffuses out to three to five times more local area. This is a major way that the pain map expands in persistent pain and keeps the pain going.
When a nerve shaft is damaged, the involved nerve cells produces much larger amounts of Substance-P, which is sent down nerve dendrites and a massive amount is released from nerve endings diffusing out into much more brain tissue.
It is also involved in maintaining the inflammatory brain-body loop, when much of the excess Substance-P is sent back down nerve axons diffuses backwards through synapses and is released from pain receptors into injured tissues.
The brain and the body are connected via nerves, but also by molecules in the immune system. This animation demonstrates the activation and continuation of inflammation in the body causing an activation of similar systems in the brain resulting in a loop being set up between brain and body. The result of this type of loop being set up is establishment of chronic inflammatory problems in the body that prevent a normal resolution of inflammation to anti-inflammation and tissue repair, healing and maintenance.
Traumatic experiences throughout life, often starting in childhood and overlooked, set the stage for excessive release of Substance-P later in life and prime individuals for the development of persistent pain states. All aspects of a person’s traumatic life experience need to be addressed in order for the treatment of persistent pain disorders to have lasting effects. Literally we have to help people replace the release of Substance-P, with soothing neurotransmitters and anti-inflammatory and healing molecules.
Look at the graphic on page 35 of the Neuroplastic Transformation workbook. It shows the limbic cortex in the brain activated with stress, anxiety, depression, and/or pain. Deeper serotonin and norepinephrine rich regions of the brain oppose this. These areas can send molecules to the limbic cortex and calm the effects of too much Substance-P release. Learning self-soothing techniques can be very helpful in controlling these problems. Because emotional circuits and pain circuits share brain regions and nerve cells there is a great overlap of pain disorders and mood disturbances. Reining the release of Substance-P can go a long way to controlling pain and mood disturbances.
When he Limbic System is activated by too little or too much release Norepinephrine or Serotonin, regulating this properly from brain centers that produce these neurotransmitters, reduces extreme emotional and painful symptoms.