When pain becomes chronic, enigmatic and intransigent some medical opinion is that it’s ‘all in the head’. Is it?

In my last post I described the neurophysiological transformation of acute pain to chronic pain. This past Fri-Sun I taught a class that explored the 50 or so muscles found north of the clavicle. We concentrated on three common pain conditions; headache, temporo-mandibular disorders (TMD) and whiplash associated disorders (WAD).

Necks and gender

Unfortunately, if you’re a woman your chances of headache, TMD and WAD are
higher than a man. A woman’s head weighs much the same as mine, but your neck may be less strong than mine. My many female clients relate the onset of their pain to a trauma, like a neck crack or a car accident. But, let’s not forget the profound effects of prolonged, sub-maximal, isometric contractions.

Prolonged, sub-maximal, isometric contractions
Imagine that you are sitting at your computer, engrossed in your work, or you’re driving, watching TV, chatting with friends, playing video games, sitting at the bar. Chances are you use a ‘forward head posture’. Many neck muscles are performing prolonged, sub-maximal, isometric contractions just to hang onto the bowling ball that is your head. If you’re a woman this can be especially tough.

The trigger point swamp
Trigger points thrive in the stagnant swamp of prolonged, sub-maximal, isometric contractions. During prolonged muscle holding and tension, contractile trigger points can form to resemble small packets of ‘pre-mortis-rigor’ (Rigor mortis is an oxygen and nutrient deprived muscle contraction). This swampy stasis is acidic and produces many nociceptive chemicals that can result in pain. Neck muscle trigger points commonly refer pain into the head.

Part 2 will explore ‘it’s all in the head’ pain from the neuromatrix theory of pain.