The
Problem Stated
Ever since my first year in practice I have had people
come into my office with the same complaint.
Their pain has returned. They
want to know why. That is never a bad question. It happens in every profession. If the Chiropractor moves a bone and gets
pressure off of a nerve and the pain comes back – what’s wrong? When the Physical Therapist prescribes an
exercise regimen which is followed in exquisite detail and the strength increase
is documented – why does the pain come back?
In my case – when the Massage Therapist calms my nervous
system and my pain goes away – why does it return? More emphatically – Why does it return when I
did nothing wrong and everything I was supposed to do!
Understanding
the Problem
The easiest thing to do in cases like this is to find a
way to blame the patient. They must have
done something wrong. I remember in my
early years as a therapist that I often resorted to this method. My work was good. You were fine when you left me. You must have done something wrong.
Of course, I did not phrase it that way. It would not have sounded kind and people
would not have returned. I learned about
something President Kennedy’s doctor, Janet Travell, had written of. She described what she called Perpetuating
Factors in this article[i].
I have gotten a lot of mileage from what she taught
me. I learned to look at many other
aspects of a person’s health that when dealt with appeared to help many of my
clients. Yet, there were a few things
that I was missing. I would like to discuss
one of them here. It is called a
Neurotag.
A few months ago I walked into my local mall. I knew where I was without looking. I could smell the cinnamon rolls. I could see them on my mother’s table. I could taste them. Yet, I was in the mall walking by Cinnabon™!
What
happened? I activated a neurotag. Let me explain. When something happens to us various aspects
of it are recorded in different parts of our brain. We have visual, auditory, and other memories
that get stored all over our brain. As
we repeat things these parts of the brain begin to all fire at the same
time. Hebb’s Law, as summarized by
Siegrid Löwel, states, "neurons wire together
if they fire together."[ii] When this happens
a neurotag is formed.
In the future
various parts of the brain will fire in other situations. The more of these separate areas fire at the
same time the more likely it is that the memory formed by that neurotag will
manifest itself. This is why I got
transported back to my mother’s kitchen table while walking through the mall.
This is not limited to people. Consider this story. The Denver Zoo received a Polar Bear but the
bear habitat was not yet ready. That was
not too big of a problem. The bear could
walk 4 steps in either direction in the cage he had been delivered in. The project would be completed quickly.
Or - perhaps someone’s idea of quickly would
not agree with the Bear’s it would not be quick at all. The bear remained trapped in that cage for 3
years before the habitat was complete!
After the 3 years there was a real concern as to what the bear might do
when released. He was darted with A tranquilizer
and the cage was removed. All eyes were
on the massive bear as he awoke. He got
up and guess what? He walked 4 steps in
either direction. His brain was now
wired that way.[iii]
As
Christians – we often find ourselves in a similar situation. Our life has been radically transformed by
God’s grace. We desire to do what is
good. Yet we keep falling back into the
same old sin. We are wired that way.
Examples
of this abound. We see it in others but
we see it most often in ourselves. We
desire to know God better. We have our
devotions. We go to church. We cry out for deliverance from our sin. Yet, we still choose to be our own idol and
choose to serve ourselves instead of Christ.
We have the tools of renewing our minds (Romans 12:1-2) and putting off old
behaviors and clothing ourselves with new ones (Ephesians 4 describes this). Apart from the work of God’s Spirit it is
literally impossible to do this.
Dealing with the Problem
In
pain it is much easier, though often incredibly difficult, to deal with our
issue. This is because of the difference
between sin and pain. Our brain seems pretty
much hard wired with use - but it can change!
It changes by paying attention to and working with the neuromatrix model
of pain.
We
have 3 major sources of input to our brain. These are our:
·
Thoughts/Beliefs
·
Sensory
Input
·
Emotions/Affections
It
is by working with these that we can often change our own neurotags. Here is an example.
Dale
had been injured about 30 years before in a hit and run accident while riding a
bicycle. He experienced a good deal of pain
in the area of his shoulder and torso that had made contact with the
asphalt. His history of pain detailed
multiple treatments over the course of time but the pain was still a daily
experience.
Changing Thoughts/Beliefs
He
learned that the stages of healing for soft tissue were pretty complete after a
couple of months with the entire healing of scar tissue complete in about a
year. That was a major change in
thought. He had been constantly thinking
about scar tissue, adhesions, and trigger points and knew all about such
things. He explained what was wrong with
his posture. Now he realized that his pain
had much more to do with neurotags and nerve irritation as opposed to some deep
seated pathology. He continued to read
in this area and changed how he thought.
He effectively dealt with the first mentioned aspect of input into his
neuromatrix – his Thoughts/Beliefs. It took work to change his thinking.
Handling and Manipulating Sensory Input
The second input into the neuromatrix that he dealt with was his Sensory Input. Rather than just passively receiving the input of his senses and the interpretation of his brain that something was “wrong” he began to use his sensory cues to change and adapt his behavior and to explore movement. His senses became his partner in pain relief instead of their former more adversarial role.
I
instructed him in some slow gentle non-threatening movements that he could do as
he paid close attention to his sensations.
The very act of focusing on the movement acted as a distraction and
showed his brain that non-painful movement was indeed possible and that it
could even be enjoyed. Many of these are
described in the book Relaxercise. I highly recommend it.
Now
that he knew that his tissues did not have hidden danger in them, Dale began to
explore movement on his own. He
desensitized the irritated nerves and retrained his brain by moving just before
the point where he felt pain. He continually
explored this area until it was no longer a threat and was able to develop to
the point where the movement was no longer painful. Cory Blickenstaff PT refers to this as
Edgework. His YouTube page is worthy of
your exploration.
Perhaps
the most freeing work that Dale performed was realizing that his habit of fidgeting
and squirming was actually healthy. He
was looking for positions of comfort that got pressure off of his nerves and
allowed the free flow of blood that they needed. This kept them from sending danger signals to
his brain. The brains response is to not
be threatened and not send pain because Dale had learned to handle it preemptively. This type of movement is inherent to our life
and is self-corrective. It is called
Ideomotor movement and has been developed as an approach by Barrett Dorko PT. He had been avoiding such movement in many
cases because he was afraid of looking strange in front of other people. He got over that!
Dealing
with the Emotional/Affective Contributors to Pain
The third thing Dale had to deal with was his fear. There was the fear of something sinister
lurking in his tissues. There was the
fear that certain movements would be painful.
There was the fear that certain positions had to always be avoided. There was fear because he had seen other
people with traumatic injuries that had been in pain for many years. He had seen their suffering. He had seen the suffering of people he
loved. Dale was pretty much
characterized by fear.
In Dale’s case the fear was able to be overcome by
focusing on what he now knew to be true.
There was nothing scary lurking in his tissues. They had healed a long time ago. He now had tools to use and a reasonable expectation
that they would work. He had irritated nerves and neurotags in his brain. He knew they could be dealt with. The
fear was replaced with confidence and he was no longer paralyzed by freeze, fight or flight.” This input from the first 2
sections of his neuromatrix helped to change the third.
Conclusion
Neurotags are a very good explanation of why we complain
of pain when we “have done nothing wrong.”
There are sometimes other contributors but this one is incredibly frequent
and rarely discussed. Neurotags can be
changed. That is the message and now you
have the information to help you to deal with yours!
[i]
Chronic myofascial pain syndromes: Mysteries of the history. In: ADVANCES IN
PAIN
RESEARCH AND THERAPY, Fricton, J.R. and Awad, E.A., Editors, Volume 17, Raven Press, New York, Chapter 6, 1990, pp. 129 – 137.
RESEARCH AND THERAPY, Fricton, J.R. and Awad, E.A., Editors, Volume 17, Raven Press, New York, Chapter 6, 1990, pp. 129 – 137.
[ii] Siegrid Löwel, Göttingen University; Löwel, S. and Singer, W. (1992)
Science 255 (published January 10, 1992) "Selection
of Intrinsic Horizontal Connections in the Visual Cortex by Correlated Neuronal
Activity". United States: American
Association for the Advancement of Science. pp. 209–212. ISSN 0036-8075
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