By Paul Williamson MSc BSc BSc MCSP HPC – Perform Physiotherapy Lead
All pain experiences are normal and this unpleasant response is what you brain perceives to be a threatening situation. Even if damage has occurred within tissues it won’t hurt if your brain thinks you are not in danger. Pain is an output from the unconscious to the conscious mind in order to change our thoughts and behaviour; an innate protection mechanism, which can dominate with chronic conditions.
Pain in the brain
There is not a single pain centre within the brain, rather there are many called ‘ignition nodes’. These different areas within the brain work together simultaneously to construct as sensible a story as possible based on information that is arriving and relevant past experiences and understandings. Past experiences can have a large influence over present symptoms; fear and stress in particular have been shown to block the opioid systems.
The Opioid system
Areas within the brain such as Periaqueductal Gray, Nucleus Raphes Magnus, Dorsolateral Funiculus all release opiates of differing ½ lives and strengths that provide pain relief to deal with most situations. However evidence suggests that fear or stress create increased activation within the Amygdala, Hippocampus and Hypothalamus, these areas have been shown to reduce the opioid systems capabilities. An important area called the Habenula Lateralis has been suggested to act as a switch and has the capability to turn down activity within the Amygdala, Hippocampus and Hypothalamus, thus allowing the Opioid system to regain its full pain relieving capability.
Acupuncture Evidence: fMRI studies
Needle insertion has been shown to stimulate the Habenula Lateralis thereby reducing activity within the Hippocampus and Amygdala thus increasing activity in Opioid systems. This essentially switches back on the body’s natural pain relieving mechanism. Research shows that brainstem structures which control slow wave sleep patterns also modulate pain processing, which suggests sleep is not only important for dynamic healing and growth. Positive autonomic effects of needling have also been displayed in addition to use with muscular trigger points that may induce an ‘energy crisis’ sensitisation of peripheral nociceptors. Research into the use of acupuncture for pain relief has been increasing for many years and has now been accepted for its therapeutic effects, most recently being recognised within the latest NICE guidelines for low back pain.
Here at Perform at St Georges Park, our Sports Physician and all Physiotherapists are fully qualified in acupuncture and regularly use it as part of their treatment regimes.