This week I want to talk a little bit about chronic pain. Anyone who has experienced chronic pain knows just how disrupting it can be. Whether it's that bout of recurrent back pain after a long drive or neck pain that comes on yet again while working at your desk; the experience is distracting and can be psychologically draining. Chiropractic care is an amazing healthcare option to help you tackle these painful episodes once and for all, but what is causing all that pain anyway? Pain science is still divided on the issue of chronic pain, which is defined as pain that lasts 3 months or longer, but one prevailing theory is the concept of the wide dynamic range (WDR) neuron becoming overly sensitized.

The WDR neuron acts as a communication hub for sensation. It takes inputs from many different peripheral neurons and passes the info up to the brain for processing. I like to think of the WDR as a river, taking water from many creeks and streams and passing that water on into the ocean, which is of course the brain in this analogy. The brain interprets the signal from there, with faster rates of firing being perceived as painful stimuli. This is useful for the brain as it condenses information and makes the vast number of electrical signals racing up to the brain at any given time more manageable. The problem with this system is that sometimes the signals get crossed. Chronic pain often begins with an injury that creates local inflammation in an area of the body. This inflammation in turn causes nerves in the area to fire converging on a WDR neuron. The WDR neuron then does its job and sends the message up to the brain. The brain interprets the rate of the signal and informs us what is going on in the injured area: pain. Pain is meant to alert us to tissue damage, and in this example the peripheral nerves, WDR, and brain have all done their job effectively and the sensation of pain is produced.

However, when we fast forward 3 months and that same area still hurts, the system is no longer working effectively. The problem is that the WDR neuron can become sensitized. This means that the neuron needs less intense signals to meet the threshold for firing. This leads to faster WDR firing rates from much lower level stimuli, but these signals are still interpreted as pain by the brain. This means that after an injury is all healed up, even normal stimuli such as normal movement or function is now being interpreted as pain. Chiropractic manual therapy helps people suffering from chronic pain by manipulating the tissue sending inputs to the WDR and changing the quality of those signals over time. Each visit we disrupt the chain of signals producing pain and over time the WDR calms down and becomes less responsive to painless stimuli: less pain.

It's important to remember that not all chronic pain fits into this model. Sometimes chronic pain is due to tissue changes such as disc degeneration or due to pressure on a nerve root, such as can be experienced with a disc herniation. Using orthopedic tests, radiographic imaging and other diagnostic tests, the pain relief experts at Excellence in Health Chiropractic will work with you to get to the bottom of your pain and help you beat that nagging discomfort that just never seems to fully go away.

Excellence In Health Chiropractic & Rehabilitation Clinic
(907) 562-6325