Change the Brain; Relieve the Pain; Transform the Person
Section 1: Introduction
Wiring New Connections
Hub Treatment
Neuroplastic transformation is the treatment hub for persistent pain disorders. When pain transitions from a symptom to a disease, it is not merely more pain, longer lasting pain or constant pain. This process is one of neuroplastic adaptation to a stimulus resulting in molecular, cellular, anatomic, physiologic, electrical and functional changes in brain and peripheral body. Varied treatments have been established to deal with the persistence of pain. Some of these are aimed at altering or suppressing peripheral sites and some use more systemic approaches to manage pain. Medication, Invasive, Bodywork and Psychosocial approaches can be used individually or in concert with each other. Multidisciplinary and Interdisciplinary treatment teams may be brought to bear. All of these treatments are aimed at containing and managing the disease of persistent pain. None are crafted to cure the underlying neuroplastic process that has caused pain to transform from symptom to disease. It is only by harnessing the power of neuroplasticity that persistent pain can be resolved.
Brain Access
We have more access to the brain than any other organ, even the skin. The brain uses the peripheral body to inform it of everything going on in the external world. It then directs the peripheral body to make adaptations to protect itself, survive and follow the Prime Directive: Avoid Pain; Pursue Pleasure. Every individual uses thoughts, images, sensations, memories, emotions, movement and beliefs to change their own brain. This brain access alters anatomic development, cellular structure, physiologic coordination, electrical circuitry, molecular activity, regional function and neuroplastic change. Everything we do, learn and master results in a change at all of these levels. This incredible access and sweeping change can be effectively used to end the tyranny of pain persistence.
Active vs Passive Rx
Using this website in conjunction with the Neuroplastic Transformation workbook is a way to expand what is a written guide to something far more. It is also a way to move from being in the role of passive patient to active leader of your own pain treatment team. While passive treatments can be very effective it is critical to shift into a model of active care between treatment sessions by constantly counter-stimulating the brain in response to pain intrusions. Look at page 8 and reread the text. Making the transition to the leader of one’s own care by understanding neuroplastic treatment approaches, completely shifts the pain treatment paradigm and opens a world of possibilities. The ultimate goal moves past pain management to that of life transformation. Go to page 16 and look at the ways real people are applying the use of thoughts, images, sensations, memories, soothing emotions, movement and beliefs to make changes in brain real estate, reassigning nerve cells to other functions by counter stimulating their pain episodes.
Provider & Patient Roles
The current model of pain care tends to place providers in the active role, performing procedures, giving medications, doing body work, intervening psychologically and recommending ways to cope and manage between treatment sessions. Patients are placed in the role of passive participants during treatment sessions and then often left to their own devices to play a more active role between sessions. Neuroplastic Transformation treatment approaches change this model of care. It remains important for providers to come up with a treatment plan and to use the professional training and skills they have to help people with persistent pain. The change here is that providers also help the patient to move toward the position of leadership in this relationship. To accomplish this the care provider must give patients specific things to try between sessions and follow up on these things when the patient returns for care. From the patient’s perspective, this would mean that the patient needs to take the provider’s ideas and dig into these to see what really works for them. Staying with old approaches, even helpful ones, because of a fear of trying something new must be put aside, as the brain focuses upon novelty. Going beyond ones interests and limits can open up entire vistas of new approaches. Providers have to allow and encourage patients to bring their ideas back to treatment to hone and refine these.
Counter-stimulating Pain
The graphics on page 10, 11, 12 and 13 are some of the most important ones in the Neuroplastic Transformation workbook. On page 10 we see the 2 regions in the spinal cord and 16 regions of the brain that make up the pain circuit. This depicts acute pain where 5% of the cells in each region are dedicated to pain processing. These nerve cells are reserved for pain and are shut off, until signaled by sensory pathways in the body to turn on due to danger in the form of injury, illness or inflammation. These signals are processed from the back part of the spinal cord, crossing over to the opposite side of the cord and sent up pathways to the brain stem and mid-brain. We only perceive the signal as pain after it reaches the thinking brain. Here in the 9 regions of thinking brain where the signal is received we experience it as pain. In acute pain some of the same regions and a few different ones send a signal back down to the spinal cord to intercept the incoming signal and shut off the pain so that it never reaches that upper part of the brain, which we use to perceive sensations.
Shrink the Map
The key graphic of the entire Neuroplastic Transformation workbook is that on page 13. This shows all of the perceptive areas of the brain where persistent pain expands the pain map, as well as many of the other functions in these same area that are being over-run by pain perception and pain stimulation. At the top of the page are the instructions to Shrink the Map, by accessing the brain with thoughts images sensations memories, soothing emotions, movement and beliefs. It is important to understand that these ways we access our brains are the keys to stopping persistent pain. The more consistent and robust the counter-stimulation to the pain the more we can take back real estate for these other functions. From simple thoughts to different sensory inputs we can teach our brains to move the relentless, persistent and constant pain signaling to comfort and pleasure.
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M.I.R.R.O.R.
We have come up with an approach to treating persistent pain that is based upon the principles of neuroplasticity:
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Continued firing of a nerve by another nerve increases the strength of the firing and the number of synapses dedicated to those nerves. (What gets fired, gets wired)
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Nerve cells that do not fire other nerves over time will lose synaptic strength and break synapses dedicated to those nerves. (What you don’t use, you lose)
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To conserve the amount of energy the brain uses, old synapses must be broken, when new synapses are formed. (When you make ‘em you break ‘em; when you break ‘em you make ‘em)
The idea called MIRROR applies these concepts. This stand for:
Motivation
Intention
Relentlessness
Reliability
Opportunity
Restoration
N.O.R.M.A.L.
The polypharmacy of pain treatment is criticized for side effects, drug-drug interactions, worsening pain states, dependency, addiction and even inadvertent death. The problem is not with the medications, but in the way they are utilized to treat persistent pain. They have become the core treatment for this disease process. If the dynamics of persistent pain are recognized as a neuroplastic process, we must view neuroplasticity as the basis for persistent pain and it’s treatment. All treatment should be aimed at creating neuroplastic change to oppose and halt the process of persistent pain. Medications are an excellent way to alleviate symptoms while working on the underlying cause, but cannot be the mainstay or central principle of any treatment program. They are a spoke in the wheel of treatment options with neuroplastic treatment at the center.
