Video and Transcript: The Connection Between Body and Brain

Hi everyone! Dr. Orit Hickman here from Pain Science Physical Therapy and I'm here to do another video on chronic pain. You guessed it. This is something that we specialize in here at Pain Science PT. 

So, in the videos that I’ve done up until this point, we really focused in on the brain and how pain is produced in the brain. The last video I did, I talked about programming in the brain, which is a huge component regarding having chronic symptoms. 

So, now I'm going to talk a little bit about the relationship between the brain and the body because we can't ignore that piece as well. So, I'm going to give you a little bit of a metaphor, something that I utilize a lot to be able to teach patients about how the brain and the body communicate with each other. So, think about a really great company to work for. 

So, in that company, you have a president and she oversees all of her different managers who also oversee people underneath them. And the people that work in each of the different departments respond and give information to those managers, and then those managers have weekly and monthly meetings with the president. A really good company runs where the managers don't have to micromanage too much and the president doesn't need to come in and see how each of the workers are doing their job. Maybe a little bit of a check-in, but not super duper micromanaging. That's not a great company to work for. 

Well, things change in the body when you've had pain for a period of time. So, let's say the president of the company finds out that there is a guy in the mailroom who's been stealing mail for five years. Well, she calls their butt down to the mailroom. She fires the mail guy and she fires the manager. She says, “You let this happen. I'm in charge now.” 

So, for a period of time, the president is going to try to run the mailroom. Well, this isn't going to work for very long because she has a lot of things that she needs to do up in her office, including overseeing the rest of the company. But, now she doesn't trust the guys in the mailroom. So, she's got to figure out a way to keep the guys in the mailroom behaving, being on their best behavior, even when there's no manager in charge. So, she decides what she's going to do is sneak attacks. So, she shows up on Monday and she sits all day in the mailroom. She's got her laptop and she’s got her cell phone. She can do most of what she needs to do. 

And, the men and women in the mailroom are freaking out: “She is totally going to fire us. Why is she hanging out here?” So, they're on their best behavior. They're like, “Okay. We have got to do our job great. We are not going to let her freak us out. We are going to be awesome. We're going to show her that we know how to do our jobs.” 

Okay, so she decides: “You know what. I'm going to give them a break.” She leaves and doesn't come back for Tuesday and Wednesday. Two days, she's gone. 

And, they think, “Hey! We can chill now. Things are good. Right?” So, this is when pain maybe calms down a little bit. 

Well, she still doesn't trust them, so she shows up on Thursday. And then, she shows up at eight o’clock, nine o’clock, ten o’clock, eleven o’clock. She starts making her visits to the mailroom super duper erratic. So before you know it, the men and women in the mailroom are totally nervous, don't trust anything, and they don't know when the next time she is going to show up. So, this is when we see nerves and the nervous system amp up and stay in a really, really protective state. 

So, now the more erratic she is about visiting the mailroom, the more amped up the people in the mailroom are going to get till they're out of state where they just have to be on their best behavior all the time. So, this might sound a little bit familiar to you. Let's say you have an injury. And, after the injury, for a period of time, your pain starts to get better, which, by the way, is really normal because tissue heals, so pain should get better. Well, what if all of a sudden you have a flare-up and you don't know why? 

Well, you probably haven't learned that nerves can be sensitive to different things like changes in temperature, stress, hormones, sometimes movement, blood flow changes, and immune cells. Because you don't know that, you don't know what's happening. Nerves amp up. You get nervous. Your brain (your CEO, your president) starts doing a lot of check-in on that area that isn't behaving itself. 

So, over the course of time, because your president is doing a lot of check-in, your nerves stay in a protective state. They stay amped up. They are ready to react at any moment. With education, we know that we can bring that system back to a resting state. So, at some point you learn, “Wait a minute. My tissue has healed. That injury happened 20 years ago. There's absolutely no reason for me to still have pain 20 years later.” As you start to learn that, it's like your president is learning how to trust your nerves again. And, you're back again if that's the area that's injured. And, your nerves calm down and your president stops checking in. 

So, it's important to note that while pain is produced in the brain, you have a lot of control over what's happening between your brain and your body. And, the more that you can interrupt the cycle, the more that you can help your brain be more confident that you're healed and that you're healthy and that you're strong and that you're not injuring yourself when you move, the less likely you are to experience pain. And, over the course of time, your nerves calm down. Your pain levels calm down. 

Hope this gives you another piece of information in this really, really complicated system that is your pain system. Let me know down below if you like this video. Leave any comments. Share it if you can and I hope you guys have a great week! Thanks! Bye.

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 me 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.