Video and Transcript: How Brain Programming Causes Chronic Pain

Hi everyone, Doctor Orit Hickman here from Pain Science Physical Therapy. I wanted to put together a short video just to talk to you a little bit about chronic pain and what this looks like in the brain.

So if you watched any of my videos before, then you’ve already learned that pain is something that is produced by the brain in response to a perceived threat. One of the things or one of the words that I use a lot with patients when I'm doing education is I talk about programming and so my question is “What is brain programming?” Right? What is that? What does that mean? Well you program in everything that you need to in your brain that you practice.

So anything that you do over and over and over again becomes an automatic program in your brain. And the more that you practice something, the well, the well, the more well-practiced it is, the more ingrained it is in the brain, the more hardwired that programming gets.

So the question is “What does that have to do with pain?”

Well, I'm going to tell you a little story that I made up and I use as a metaphor for patients.

So let's say you go to the grocery store and you decide to buy some yogurt. I don't know about you. I am not a yogurt eater. I am lactose intolerant, but will suspend disbelief right now and assume I am buying yogurt.

So I go to the grocery store. I buy some yogurt. I'm standing in line and there is a young lady behind me and she taps me on the shoulder and she says, “Can you tell me a little bit about your yogurt? I'm thinking of switching brands.”

Sure, so we chat for a few minutes. I tell her about my yogurt. I then pay for my yogurt and I leave the store. I never see her again. The chances that I would remember her and remember this interaction five years later. Probably not going to happen.

So many other things that are going on in my life. This took less than 5 minutes. Nothing significant happened. No big deal.

Let's change the story a little bit.

So let's say I'm online buying my yogurt. A young lady taps me on the shoulder. She says, “Hey, I'm interested in changing yogurt brands. Can you tell me a little bit about your yogurt? And I say, “Sure.”

So we start chit-chatting and then, out of nowhere, she pops on the nose. I have blood gushing everywhere. People come running from all areas of the store. “Oh my gosh, Mrs. Hickman, we’re so sorry. We're going to give you free yogurt for a year.”
Deal, this young lady is freaking out. She's screaming at me. She's crazy. They dragged her out of the store.

Now how likely am I going to be to remember that experience? I'm sure you could already say I'm not going to forget it.

Well, here's the way that programming works. As soon as this trauma occurs, it's almost like somebody has taken a blender, taken the cap off the blender, hit “Blend” and all the items in the blender go whoof and they go splat all over my brain.

So I have lots of areas of my brain that have stored different pieces of information regarding this trauma. I have a part of my brain that remembers how it smelled in the store. I have a part of my brain that remembers what this woman looked like as she's yelling at me. I have a part of my brain that remembers the pain of having a broken and bloody nose. I have a part of my brain that remembers what the sounds were that were around me.

This is a very, very complex thing that happens in the brain and it happens very quickly when there's been a trauma.

So now let's fast forward a week or two and I decide, okay, even though my nose is healing and not fully healed, I still want yogurt. So I come in this store and when I come in the store, I go to pick up my yogurt and I have a memory of this experience and I decide “You know what? I'm going to try a different yogurt.”

So I go ahead and I switch yogurt and as time goes on I'm now switched. I've now switched my yogurt and I don't necessarily thoroughly remember this experience every single time I come in the store, at least not consciously.

But, overtime I become uncomfortable in the store. I don't want to shop in there anymore, In fact, I don't want to buy yogurt anymore and if it gets bad enough, over time, the bigger the programming gets, I'm not likely to even travel to Greece where they serve a sauce which is made with yogurt.

Right? This trauma has become bigger and bigger and bigger in my brain. It now affects where I go to shop and now affects where I go to travel. It's pretty complicated.

So this is just to give you a little bit of an idea of how complex pain is in the brain. And it's part of the reason why it's so challenging to treat chronic pain.

So we're going to stop there. It's my short little video on programming and the brain.

Definitely let me know if you liked the video by giving me a thumbs-up. Put any questions down below, any comments. I'm happy to answer them and I hope you guys have a great day. Thanks. Bye.