Long term pain, the brain and the pudding tummy.
Pain is fascinating and seriously weird. It is much studied. It can happen that we suffer a trauma in the body, for example slip a disc or break an ankle and in due course, the trauma has largely healed and yet we still feel great pain in the affected area – we fear using that part of the body.
Much should be done to aid full rehabilitation, very much including restoring the full sensation maps. But even if this has happened, we can still feel pain there.
So what’s going on? Studies have found that part of the brain becomes unbalanced in people suffering long term pain. The area is in the frontal lobe of the brain and is to do with decision making. It has two parts, one is very emotional and the other very deliberate -unemotional. Their names are the vmPFC ( ‘very emotional pre frontal cortex) and the dlPFC (deliberate pre frontal cortex). (Thanks to Robert Sapolsky and his great book: Behave.) When we make a decision, these two areas work together for a balanced choice. A good example of this in action is the ‘pudding tummy’. We feel satisfied after the main course but our pudding tummy is still empty. Hah. This is eating due to feeling, not the hard reality of how hungry we are. The desire for sweet food comes from the limbic system, specifically the insular lobe of the brain. Eating sweet food is calming, but not necessarily good for our waistlines or health.
And so in long term pain these two areas become unbalanced. The fear of moving grows and that brain area increases in size and the hard reality part of the brain, the deliberative part, decreases.
What to do? Train this deliberative part of the brain. The most effective way is with a partner and the simplest is to play hand/foot. The trainer says hand and the trainee taps a hand, the trainer says foot and the trainee taps a foot. Either right or left will do. After a few rounds of this, now when the trainer says hand, the trainee taps the foot. If that’s quite easy, make it harder: right hand equals left foot. Do this for a few minutes then swap. Then you’ll definitely need a cup of tea and a biscuit.
Training without a partner is also good – you need to download a Stroop Test app. Android version is Stroop Tests for Science, Apple version is Stroop Effect. There are other STroop apps available, these 2 are just ideas. The picture explains how to do it.
