[Brain Science x Body Theory vol.16] Why does it still 'hurt' even after the wound has healed? The 'true nature of pain' from Descartes to modern brain science
Hello, this is Logical PT.
"There are no abnormalities in the tests, but my lower back feels heavy all the time." "The place where I was injured in the past starts hurting again when the weather is bad."
Are you suffering from such "prolonged pain"? In fact, the common sense regarding pain is being completely rewritten in the world of rehabilitation right now.
This time, while unraveling the "history of pain" that began with the 16th-century philosopher Descartes, I will logically explain the "pain trap created by the brain" that the latest brain science has elucidated.
1. The "one-way" misunderstanding depicted by Descartes
The 16th-century philosopher Descartes compared pain to a "bell-ringing rope." When a foot touches fire, the stimulus travels to the brain like a rope, and the bell in the brain rings. In other words, it is the idea that "the cause of pain lies in the painful area itself."
Because this idea is very easy to understand, many people still believe that "back pain means a bad back." However, modern medicine has graduated from this "one-way model." This is because the phenomenon of "feeling intense pain even though there are no abnormalities in the body anywhere" has been proven by brain science.
2. "Pain" is created by multiple departments of the brain
According to the latest findings, pain is not just a "sensation," but is considered to be an "emotional experience" created by multiple areas of the brain through a consensus system.
Insular cortex: Integrates unpleasant sensations from the body.
Anterior cingulate cortex: Directs attention to pain, saying "I hate this!" or "I want to avoid this!"
Amygdala: Implants "fear" or "anxiety" into pain.
In other words, when stress or anxiety is high, these departments of the brain become hypersensitive, and even if the signal from the body is weak, they ring a "loud bell (intense pain)."
3. Why can't we escape the "vicious cycle of pain"? (5D and the Fear-Avoidance Model)
Tissue damage should heal in a few weeks. Yet, why does "chronic pain" that lasts for more than 3 months occur? The true nature of this is the "Fear-Avoidance Model."
Fear: Anxiety that "it might get worse if I move."
Avoidance: Stopping movement, resting too much.
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5D Syndrome:
Disuse (decline due to lack of use)
Disability (physical impairment)
Distress (suffering)
Dependence (dependency)
Depression (depression)
Lack of movement leads to a decline in muscle strength and flexibility, and further reinforces the brain's learning that "moving hurts." This "loop of brain malfunction" is the true nature of pain.
4. Tricking the brain: Lessons from the rubber hand illusion
There is an interesting experiment that shows that "pain is created by the brain." That is the "rubber hand illusion".
When you are made to believe that a fake rubber hand is your own hand, and the rubber hand is tapped, the person's brain reacts as if "my hand was tapped!" and shows pain or a stress response. This means that the "body map (body schema)" that the brain possesses can be easily rewritten by vision and memory.
Conversely, if you utilize this property of the brain, it is possible to "rewrite" the pain circuit through appropriate imagery therapy and exercise.
Summary: Pain is a "dialogue between the brain and the body"
Rehabilitation until now has focused only on the "painful area (lower back or knees)." However, the perspective of pain rehabilitation is different.
Biological factors (posture and inflammation)
Psychological factors (fear and anxiety)
Social factors(work and relationships)
Considering these three as a set, the Biopsychosocial model (BPS model), is the shortest route to graduating from pain.
Your pain is by no means 'all in your head.' However, the cause is not solely in your 'bones' or 'joints' either. Let's logically deactivate the 'emergency alarm' that your brain keeps sounding.