Pain Science Primer

Introduction

Besides being good for the sake of knowledge, research shows that simply learning about pain helps alleviate it!

First, we’ll look at 4 “essential pain facts” laid out by pain researcher Lorimer Moseley with commentary from me. I like his way of framing your pain system as helpful but which sometimes needs to be reprogrammed.

Four Pain Facts

1. Pain protects us and promotes healing

Of course if you sprain your ankle, it will hurt. However, pain primarily does not indicate damage so much as it protects us from damage. “Don’t roll your ankle again!” The pain limits your range of motion so that there’s no chance for it to roll again. You can’t heal if you keep injuring it. If pain is persistent, your nerves become hypersensitive, leading to chronic pain.

2. Chronic pain overprotects us and prevents recovery

Carla Shatz pointed out that “neurouns that fire together, wire together”. Chronic pain results in your nervous system getting better at producing pain as the connections are reinforced. Changes in our central nervous system make us more sensitive, and this can become difficult mentally. My experience with excruciating, debilitating disc herniations made me want to avoid certain movements with my spine. However, we should be striving to recover those movements safely and pain-free instead of continuously guarding against them. It was shocking to me to learn that many people have disc herniations without nearly the same level of pain I experienced.

3. Many factors influence pain

Tissue damage is an obvious one, but stress, fatigue, trauma, hormones, etc. can all play a role as well.

4. There are many ways to reduce chronic pain and to slowly retrain the nervous system to its normal settings

Rolfing is one of those ways! But it’s important to look at what else you can do to help your healing process. You should see that you’re resting properly and not having your body do too much, too early. Get sufficient sleep, and so on.

Top-Down vs. Bottom-Up Processes of the Brain

One way to think about a lot of what goes on in your brain is to consider “top-down” vs. “bottom-up” processes. “Top-down” processes are those that start with our analyzing/thinking forebrain and get directed to the rest of the brain (e.g., visual cortex, motor cortex, memory). For example, I’m far likelier to notice a needle in a haystack if I’m consciously looking for one. Having this goal lights up parts of my brain associated with the color gray, and so on. A “bottom-up” process is when some part of my lower, sensing brain thinks something needs to be brought to my conscious attention. I may see a glimmer of the needle in the sunlight. Without bottom-up processes, you wouldn’t wake up when there’s a sudden, loud noise while you sleep.

Learning about the science of pain is a top-down way of turning down your sensitivity to pain, but these things take time. Chronic pain doesn’t develop overnight, and it likely won’t resolve itself overnight, though there can be quick breakthroughs!

The efficacy of Rolfing can in part be thought of as a bottom-up process in 2 ways: lowering the dial on pain and enhancing proprioception.

1. Desensitizing the Nervous System

Through touch and movement, especially in areas where your body is sensitized or protecting, your nervous system learns that the soft tissues can be touched or stretched without doing damage. This can help you get back to normal, healthy movements you’ve been lacking. Of course you shouldn’t spend all your time curving your spine, but you should be able to bend over and tie your shoes without pain.

2. Enhanced Proprioception

Proprioception is your sense of your body in space. It’s why you can touch a fingertip to your nose with your eyes closed. Even single-celled organisms need some sense of proprioception. Plants can orient towards the sun. “Where am I in relation to other things that I want to ingest, avoid, etc.?” Research has shown that fascia contains proprioceptors and contractile elements and is far from an inert substance.

Applying Pain Science to Bodywork

Understanding how pain works can help us move past chronic discomfort and regain confidence in our bodies. Manual therapy approaches like Rolfing® Structural Integration, myofascial release, deep tissue massage, and medical massage can all play a role in desensitizing the nervous system and improving movement. If you're interested in how hands-on bodywork can support pain relief and mobility, you can explore all of my services here.

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James Tremblay is a Certified Rolfer® and Licensed Massage Therapist based in Farmington, Michigan, serving Farmington Hills, Novi, West Bloomfield, Southfield, Livonia, and beyond.