Pain and the head

In my last post I described how chronic head pain might be perpetuated by the presence of trigger points imbedded in tissue that is in constant tension; in this case the peripheral can switch on the central. Another viewpoint to explain pain’s chronicity is called the neuromatrix theory, as promoted by Lorimer Moseley, professor at the University of South Australia and author of the book ‘Painful Yarns’.

The Neuromatrix Theory
Because you don’t need a body part to have a pain (phantom limb pain) the neuromatrix theorists believe that chronic pain is not a direct or proportional response of sensory input following tissue injury. Rather, the parts of the brain that produce pain have changed (neuroplasticity) according to sensory experience, emotions, personality and genetics. This maladaptive change (central sensitization) may involve prior hyper-excitability at dorsal horn level, facilitation (amplification) at cerebral level or inhibition of the inhibitory system.

Body in Mind
Is neuroplasticity an example of chronic pain really being ‘all in the head’? Lorimer’s website in Australia is www.bodyinmind.org (There is no mention of a trigger point anywhere on his site, which to us is quite puzzling).

The Neuromatrix Methodology
In order to interrupt the chronic pain cycle these matrixers promote psychological modalities including guided imagery, cognitive behavior therapy, and fear avoidance models. Research to back their effectiveness is robust. Other cognitive interventions can include biofeedback, mindfulness and relaxation therapies. They conclude that good for the mind is good for the body.
To be continued…