Neuroplastic Pain
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blog post written and designed by dr. sarah strandholt, dc
Neuroplastic pain is a type of chronic and often debilitating pain that arises from the nervous system due to altered processing and interpretation of pain signals. Over time, the nervous system becomes sensitized to pain, it learns and predicts pain even in the absence of a painful stimulus. This condition can be explained more easily by understanding neuroplasticity, which refers to the brain and nervous systems ability to grow, change and reorganize neural connections and pathways based on experiences and new learning. In neuroplastic pain, the nervous system goes through a wind up period, in which it becomes sensitized to normal or subnormal pain signals due to altered pain processing and the growth of new pain pathways.
One of the key characteristics of neuroplastic pain is that it is not the same as nociceptive pain, which is caused by injury or damage to the body. Nociception is the nervous systems process of encoding painful stimuli, converting it to a signal that is recognized by the nervous system so the individual avoids the perceived threat or danger. Nociceptive pain is a normal response to injury or damage and is typically resolved once the injury or damage has been treated. Neuroplastic pain on the other hand, is not resolved by treating the injury or damage and requires a different approach to treatment, often involving a multimodal approach.
The exact cause of neuroplastic pain is not fully understood, but it is thought to be a result of a combination of factors such as chronic stress, inflammation, and injury to the nervous system. There have been MRI studies examining the brain’s of people suffering from chronic pain revealing increased brain activity in regions of the brain responsible for interpretations and emotions, linking a cognitive component to pain.
Neuroplastic pain can develop in anyone, due to a variety of factors, some risks include;
History of chronic injury, surgery, or nerve damage: With continued nociceptive signaling, or repetitive exposure to a painful stimulus, the nervous system starts to learn and predict the presence of the painful stimulus, even in the absence of it, leading to learned neural pathways.
History of chronic pain conditions such as fibromyalgia, chronic pain syndrome and complex regional pain syndrome.
Chronic stress or emotional trauma: leading to changes in the way the nervous system processes pain signals, increasing risk of neuroplastic pain.
Inflammation: Inflammation in the body can contribute to the development of neuroplastic pain.
Genetics: Certain genetic factors may increase the risk of developing neuroplastic pain.
Age: As we age, our nervous system may become more susceptible to changes that can lead to neuroplastic pain.
It’s worth noting that neuroplastic pain can also develop without a clear cause, and sometimes it can happen to people with no previous history of pain or injury. It is always a good idea to work with a healthcare professional to develop an individualized treatment plan if you suspect you may be experiencing neuroplastic pain.
The symptoms of neuroplastic pain include;
Pain lasting longer than 3 months
Reported pain that cannot be entirely explained by nociceptive or neuropathic mechanisms.
Regional pain distribution rather than specific area of pain
Pain that moves around
Intermittent pain
Clinical signs of pain hypersensitivity
May be accompanied by other symptoms such as fatigue, sleep disturbances and depression.
Treatment of neuroplastic pain typically involves a combination of medications, physical therapy, and psychological therapy. Medications used to treat neuroplastic pain include anti-inflammatory drugs, pain killers, antidepressants, and anticonvulsants. Manual therapy and exercise therapy such as massage, chiropractic and physiotherapy can help to reduce symptoms of pain and improve function. Psychological therapy can help to address the emotional and psychological aspects of chronic pain, and work to develop individualized coping mechanisms to overcome and manage pain. It is important to work with a qualified healthcare professional to develop an individualized treatment plan for neuroplastic pain. With the right combination of treatments, it is possible to manage and even reverse neuroplastic pain and improve quality of life.
Overall, neuroplastic pain is a complex and often debilitating condition that requires a multi-disciplinary approach to treatment. It is important to note that all pain is both physical and mental, by understanding the underlying mechanisms of neuroplastic pain and working with a qualified healthcare professional, it is possible to overcome pain.
Written By: Dr. Sarah Strandholt, DC
References:
Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009 Sep;10(9):895-926. doi: 10.1016/j.jpain.2009.06.012. PMID: 19712899; PMCID: PMC2750819.
Nijs J, Lahousse A, Kapreli E, Bilika P, Saraçoğlu İ, Malfliet A, Coppieters I, De Baets L, Leysen L, Roose E, Clark J, Voogt L, Huysmans E. Nociplastic Pain Criteria or Recognition of Central Sensitization? Pain Phenotyping in the Past, Present and Future. J Clin Med. 2021 Jul 21;10(15):3203. doi: 10.3390/jcm10153203. PMID: 34361986 PMCID: PMC8347369.