By: Dr. John Conde Special to the Boca and Delray newspapers
Current research is pointing towards faulty brain processing as the causative agent of chronic pain. Chronic pain can be disabling, limiting major activities of daily living. It affects approximately 20 percent of US adults, 8 percent exhibiting high impact chronic pain which is defined as pain limiting at least one major life activity. Women are typically more often affected than men. The areas of the nervous system most involved seem to be the brainstem, frontal lobe, parietal lobe, and spinal cord. Areas of the limbic system which regulates mood seem to be involved as well. Due to this faulty brain processing the brain becomes very efficient at transmitting pain so that even a soft touch may produce a pounding sensation. Over time, an individual may experience pain even without a pain producing stimulus or injury. This metamorphosis is called maladaptive plasticity which has a negative effect as opposed to the beneficial aspects of adaptive plasticity. If the pain lasts more than 12 weeks it is typically termed chronic pain.
Another area of involvement is what is termed the autonomic nervous system. This is a part of the nervous system that regulates blood vessel diameter, diaphoresis (sweating), digestion, gland activity, and heart rate to name a few. Many individuals with chronic pain exhibit dysautonomia, or dysfunction of the autonomic nervous system. In fact, this part of the nervous system which is usually not involved in pain transmission actually begins to transmit pain. In addition to this, these other conditions can also be seen which include irritable bowel syndrome, insomnia, xerostomia (dry mouth), irregular heartbeat, and even excessive sweating. The autonomic nervous system is regulated primarily by the frontal lobe region of the brain and an area in the brain stem called the reticular formation.
The human brain is highly plastic (changeable). Sixty percent of the brain is genetically predetermined while forty percent is constantly changing according to environmental influences (work, home, exercise, food, etc.) We also know that our brain cells require oxygen, proper nutrients, and stimulation for optimal function. Understanding these concepts, neurophysiologic rehabilitation utilizes oxygen acquiring techniques, nutrition, and specific forms of stimulation (light, sound, touch, oculomotor (eye) exercises, one-sided balance exercises, cognitive exercises, one- sided chiropractic adjustments, mirror therapy) targeted to the under functioning brain regions in an effort to provide stimulation.
A novel, well researched, and very effective protocol is termed graded motor imagery which involves exercises that “trick” the brain into thinking the area of pain is normal therefore regulating proper neurological activity. The goal is to restore proper function and enhance the gaiting of pain. Some examples of this include mirror therapy and visualization type exercises. Most recently, a therapy termed repetitive peripheral somatosensory stimulation (RPSS) has been used extensively to stimulate pathways that lead to the brain. This therapeutic regimen utilizes a device called a nerve stimulator which can be applied to major nerve around the body including the face to create a robust level of activation.
Lastly, Class IV High Power Laser Therapy has been proven to be effective in treating some of the sore and tender points in the musculoskeletal system. This therapy, also known as photo-bio-modulation, sends particles of light called photons trans-dermally into the cell level. The photons dock on receptor sites on the cells and trigger the cells to produce more proteins and energy, thus stimulating the healing effect. This is the gold standard in conservative treatment of the tender points in chronic pain.
Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach and can be reached at 561-330-6096, firstname.lastname@example.org, www.thecondecenter.com