Ep 48: The Effects of Chronic Pain on the Nervous System Pt 1

Chronic and persistent pain is not just a physical sensation. Instead, it's a complex experience influenced by your brain structure, your nervous system activity and your emotional processing. And one way it reveals itself is via dysregulation in your nervous system. But how does it show up? In this episode, I'll explain it to you.

So get your journals and get ready to jot down this info. This is part one of a two-part episode series, where I'll first map out your overall nervous system and thoroughly walk you through the states of your sympathetic and parasympathetic nervous system. 

In this episode, I'm focusing on your sympathetic nervous system and I'll explain two effects that chronic pain has on the nervous system.

Transcript

Yeti Stereo Microphone-2: 0:00

Chronic and persistent pain is not just a physical sensation. Instead, it's a complex experience influenced by your brain structure, your nervous system activity and your emotional processing. And one way it reveals itself as via dysregulation in your nervous system. But how does it show up? In this episode, I'll explain it to you. So get your journals and get ready to jot down this info. This is part one of a two-part episode series, where I'll first map out your overall nervous system and thoroughly walk you through the states of your sympathetic and parasympathetic nervous system. In this episode, I'm focusing on your sympathetic nervous system and I'll explain two effects that chronic pain has on the nervous system. In part two, I will explain the states of your parasympathetic nervous system and explain three more effects that chronic pain has on it. Understanding these effects will help you consider approaches that support your nervous system regulation and what you consider teaching to help your students. I'm excited. So let's get to it.

1:17

Welcome to the Essential Conversations for Yoga Teachers podcast with me. I'm Monica Bright, and I've been teaching yoga and running my yoga business for over a decade. This is the podcast for you if you're a yoga teacher, you're looking for support, you love to be in conversation, and you're a lifelong student. In this podcast, I'll share with you My life as a yoga teacher, the lessons I've learned, my process for building my business, and helpful ideas, tools, strategies, and systems I use and you can use so that your business thrives. We'll cover a diverse range of topics that will help you whether you're just starting out or you've got years under your belt and you want to dive deep and set yourself up for success. I'm so glad you're here. Listen, I don't take myself too seriously, so expect to hear some laughs along the way. Now, let's do this together.

Yeti Stereo Microphone-2: 2:26

Welcome back to the podcast. I'm Monica and I'm so glad you're here because today we're diving a little bit deeper into your nervous system and pain and how the two are intertwined and the effects. Long-term pain have on your nervous system. Before we get started. Remember to download my latest freebie for you. It's the ebook sequencing for different injuries. The link is in the show notes below. I promise you it will help form a foundation for teaching students with injuries, and it will be a great resource for you to return to again and again. So download it. let's start with a nervous system refresher. Your nervous system is your body's main communication network. It sends messages between your brain and different parts of your body to control everything you do from moving and breathing. To thinking and feeling it is comprised of two main parts. First, the central nervous system. This includes the brain and spinal cord. Think of the central nervous system as the command center, your brain. Interprets information and makes decisions and the spinal cord carries messages back and forth between your brain. And your body. The second main part is the peripheral nervous system. Your peripheral nervous system includes all the nerves that branch out from the spinal cord and reach every part of your body. It's like your body's delivery system, carrying messages to, and from the central nervous system so that your body can react to different situations. The peripheral nervous system has two main branches. The somatic nervous system and the autonomic nervous system. Very briefly, your somatic nervous system controls, voluntary actions in your body, the things you decide to do, like moving your arms and legs. Turning your head. And walking, sitting or deciding to stand up. The somatic nervous system also sends sensory information like touch. Taste and temperature back to your brain. Now your autonomic nervous system controls your involuntary actions, which include functions like your heart rate, your digestion and your breathing. You don't voluntarily take these actions. They just happen. think about it since you started listening to this episode, do you know how many breaths you've taken? No, because you've just been breathing. The same with your heart rate and you digesting your morning coffee or any other meal throughout the day. It just happens. The autonomic nervous system has two branches that keep your body balanced and responds to changes around you. These I'm sure you're very aware of the sympathetic and the parasympathetic nervous system. And this episode will cover the states of the sympathetic nervous system And in next week's episode, I'll cover in depth, the parasympathetic states of your nervous system. As I've mentioned earlier, your sympathetic nervous system has several states, which are primarily based on levels of activation and your body's response to. Perceived stress or danger. The main states include these. The first is the baseline or resting state in this state. The sympathetic nervous system is not highly active. It just maintains a low level Background present. Your heart rate, blood pressure and other bodily functions are balanced. With the parasympathetic system, primarily promoting calmness. And recovery. Next is the alert or the aroused state. This is the first level of sympathetic activation in response to a mild stressor. For example, if you see something startling, Or if you hear a sudden loud noise, your body increases its alertness and readiness. However, your reaction is short-lived. If the stressor isn't prolonged. Your heart rate might slightly increase and your body is more attuned to your surroundings, but it hasn't yet moved into full fight or flight. Then there's the fight or flight state. Here, the sympathetic nervous system is highly activated, due to a real or perceived threat. Hormones like adrenaline and cortisol are released, which causes an increased heart rate, faster breathing, pupil, dilation, and redirects blood flow to your muscles. Your digestion slows down and your energy is quickly mobilized for rapid action, either to fight off the threat or to run from it. This state is intense, but it's also typically short-lived when the threat is resolved. The next state is the free state and episode 46. What is functional freeze? I started to lay the foundation for understanding this state of your nervous system. So if you haven't listened to that episode, go back and listen to it because I explained a lot in that episode that I won't necessarily explain here, including misconceptions about it and how you might find yourself in the free state. As well as how to get out of the free state. When a threat feels overwhelming and escape doesn't seem possible. Your body inters of freeze state. The sympathetic nervous system. Combined with certain parasympathetic responses causes a kind of shutdown or immobilization. This state might involve a numbing effect, dissociation or a temporary. inability to move or respond. While the freest state involves both the sympathetic and parasympathetic systems. It's still considered a survival mechanism related to sympathetic activation. Finally there's the hyper arousal state or chronic sympathetic activation. You find yourself in this state when your sympathetic nervous system remains persistently activated over time. Keywords here over a long period of time. This is often due to prolonged or unresolved stress your symptoms might include chronic anxiety, hypervigilance, insomnia, elevated blood pressure and increased heart rate. Long-term activation of the sympathetic nervous system can strain your body and lead to health issues, including high blood pressure, digestive issues and impaired immune function. Okay. Those are the five stages of the sympathetic nervous system. To recap. They are the resting state. The alert or aroused state. The fight or flight state. The free state. And hyper arousal. In next week's episode, I will break down the parasympathetic nervous system and all of its states. My intent is not to overload you with information. Instead, I want these episodes to be as easy to digest as possible. And when it comes to the nervous system and pain, you can't just learn it all in an hour. Now that we've covered the overall nervous system and I've broken down the sympathetic nervous system. Let's dive into how chronic pain affects it. There are five major ways chronic pain affects your nervous system. There's central sensitization. Altered brain structure and function impaired descending pain modulation. Hypervigilance and nervous system activation. And emotional and cognitive affects. Beyond the lookout for part two, where I'll cover the parasympathetic nervous system, as well as the last three main effects on your nervous system due to chronic pain, those will be impaired descending pain modulation. Hypervigilance and nervous system activation and emotional and cognitive effects. In this episode, I'm going to focus on the first two central sensitization and altered brain structure and function. I'll explain these to an offer an analogy for each, which might help you to understand the concepts a little better. So if you're not taking notes yet, this is a good time to do so. Or remember to come back to this episode to listen again. Okay. The first effect is central sensitization. It's when persistent pain leads to an amplification of pain signals. In the spinal cord and brain. Making your nervous system, more reactive to pain over time. This heightened sensitivity or central sensitization can cause normal sensations to be perceived as painful. And mild pain to feel more intense. Central sensitization is a process where your nervous system becomes more sensitive to pain over time. Amplifying pain signals and creating heightened reactivity to both painful and non-painful stimuli. Take a moment and imagine your nervous system, like a volume knob on a stereo that usually stays at a comfortable, moderate volume level. Central sensitization is like the volume knob that's been turned up too high. Making every sound. Uh, whether it's a whisper or a shout seem incredibly loud and overwhelming. Normally when you experience pain, it's because nociceptors the pain sensing nerves detect something potentially harmful and send signals to your brain. In acute pain, these signals travel up the spinal cord and alert the brain to take protective actions. The brain assesses the threat and decides whether to trigger pain based on the injury past experiences. Emotional context and other factors. With central sensitization, this process changes though. Repeated or prolonged pain signals from an injury. Because the spinal cord and brain to become trained. To expect pain over time. These regions adapt by increasing the number of receptors and the sensitivity of nerve cells to pain. This heightened sensitivity makes the nervous system more reactive to stimuli. Interpreting them as painful, even when they aren't actually harmful. Here's the thing. Central sensitization doesn't just affect the pain sensing regions of your nervous system. It also alters how your entire nervous system. Functions. Here's how first it increases sensitivity to painful and non-painful stimuli. Because your volume knob is turned up minor sensations, like a light touch, gentle movement. Or even changes in temperature. I can feel painful. This makes it challenging to go about daily activities as routine sensations are perceived as discomfort or even severe pain. Your pain threshold also decreases the threshold at which sensations are felt as painful becomes lower. For example was central sensitization. You might find that mild pressure on a muscle feels as intense as a deep bruise. This lower pain threshold can make you more cautious and sometimes fearful of movement. Leading you to worry that any activity might cause you pain. Also think about this, the constant input of false alarms pain signals that aren't associated with actual tissue damage. Can increase a state of ongoing stress for your nervous system. Your body's fight or flight system might stay activated. More than normal leading to increased tension, anxiety and reduced resilience over time. And finally chronic pain can influence areas of your brain involved in emotions, memory, and focus. So you might feel stressed. Anxious or even depressed. You might develop what we call a pain memory, where you expect or anticipate pain, even when no harmful stimulus is present. These emotional and cognitive impacts can amplify your sensitivity and make your pain feel even more intense. So, let me give you another analogy for central sensitization. Think of central sensitization, like a smoke detector in your home. Normally the smoke detector only goes off when there's a real fire or something burning, signaling you to take action. But in a sensitized system, the smoke detector has become overactive. It now goes off at the slightest hint of smoke, like when you're cooking or even when there's no smoke at all. The detectors response is no longer accurately related to actual danger. But it's still sounding an alarm. That's really hard for you to ignore. If you experience central sensitization, the smoke alarm is your nervous system. Which starts to detect pain in situations that wouldn't usually cause it. This constant alarm changes your relationship with your body and makes it hard to trust whether sensations are actually safe or harmful. Since central sensitization is a nervous system condition. Recovery often focuses on calming the nervous system and retraining it to respond more accurately. Practices like gentle movement. Breathing exercises, mindfulness and gradually introducing activities can help turn your volume knob down, training your brain and body to interpret sensations more accurately. Understanding this concept can help you guide students through slow gentle movements. Even restorative or meditative practice that will allow their nervous system to feel safe and reduce the impact of central sensitization over time. That's central sensitization. But chronic pain doesn't just affect the nerves and pain pathways. Over time. It actually changes. Your brain's structure and function. Reshaping how it processes and experiences pain. These changes can make the brain more reactive to pain. And emotional distress, creating a cycle that's challenging to break. You may be wondering how does chronic pain alter your brain structure and function? Persistent pain can reshape parts of your brain. Uh, particularly areas evolved in pain, perception, emotion and cognition. Like the prefrontal cortex, the thalamus and the amygdala, this rewiring can heighten pain, sensitivity. And emotional responses leading to increased anxiety, fear, or depression associated with pain. When your pain is prolonged, certain areas of your brain start adapting to process it more frequently becoming wired for pain. Your prefrontal cortex area of your brain is responsible for decision-making emotional control and planning. Chronic pain can reduce its volume and the activity which can impair your focus. Decision-making and emotional regulation. You are a, McDilla known as your brain's emotional alarm. Is hyperactive in chronic pain. Signaling distress. Even when no immediate threat exists, this constant activation can heighten fear, anxiety and stress leading to greater pain sensitivity. Your thalamus acts as a relay station, filtering sensory information, including pain to your brain. Chronic pain can lead to changes here, making your brain more responsive to even small amounts of pain. Which can make pain feel more intense. And finally the sensory cortex is the part of your brain that maps and perceives body sensations, including pain. With chronic pain, your sensory cortex becomes more sensitive to the affected body parts. Creating an exaggerated pain response. These structural changes in your brain affect how your nervous system functions as a whole leading to increased pain sensitivity, where your brain becomes tuned in to pain signals, even small ones. Causing your body to feel pain more easily and intensely over time, even minor sensations or slight discomforts are processed as pain. Making your everyday activities more challenging. Since chronic pain, rewires areas of your brain involved in emotions. You can often experience higher levels of anxiety, depression, or stress. This emotional load can make pain worse because the emotional centers are now more active. And reactive. And perceive minor pain as a larger threat. You may feel foggy or struggle to concentrate because chronic pain can impair memory and focus as your brain's resources are overly focused on monitoring and managing your pain. And finally your brain can develop a memory of pain. Which is like a learned response to certain triggers, making your brain more likely to anticipate pain. For example, if you associate a specific movement with pain, you may start to experience pain even before moving and that's wild. Here's an analogy to help you understand altered brain function. Think of your brain, like a roadmap with many routes for processing information, when pain is short-term, it's like taking a minor detour, your brain processes, the pain sends the signal to heal and the road is clear again. But with chronic pain, it says if a traffic jam builds up on the pain processing roads, Your brain starts rerouting signals and building more pathways, dedicated to pain processing, making it harder to take the usual route. For normal sensations and emotions. This creates a pattern where your brain over prioritizes pain pathways, like turning small side roads into highways, specifically for pain signals over time. This makes the brain better at sensing and responding to pain while other routes. Like those for joy, relaxation, or focus shrink. Leaving you stuck in traffic on the pain pathways. These brain changes, make it difficult for you to distinguish between real danger and normal sensation. Pain is perceived more readily and intensely. And every day activities or emotions can trigger the pain response. This cycle of alter brain function can lead to a reduced quality of life. Increased anxiety or fear around movement or certain activities. And challenges in concentration and memory, making your daily tasks and work more challenging to complete. When you understand these potential changes in your brain or your student's brain. It emphasizes the importance of teaching mindfulness. Teaching relaxation and super gentle movement and pain management. Practices that promote your brain's ability to rewire itself can gradually help shift your brain's function away from pain dominant patterns. Try incorporating practices that balance relaxation and feel like safe movement, which can support students in untangling their pain pathways, and nurturing a sense of calm control and resilience in their brain and body. All right. That was a lot. But this episode was so juicy filled with information to help you understand the nervous system and the effects chronic pain has on it. I love this episode so much. And it's one that you should listen to multiple times so that the information sticks and makes sense. Have you ever watched a movie more than once I have interstellar is my favorite movie. And every time I watch it, I think I'm going on about 15 times now. I see or hear something new. So again, listen to this episode again and again, and I guarantee you'll pick up something you missed the last time you listened. Again, next week. Look for part two where I'll cover the parasympathetic nervous system. As well as three other main effects on your nervous system due to chronic pain. Those effects are going to be impaired descending pain modulation. Hyper vigilance and nervous system activation and emotional and cognitive affects. If you can't tell already, I love talking about anatomy, pain, injuries, and pain science. And I want all teachers of movement to understand how a working knowledge of it affects your teaching. I don't think we talk about the importance of pain and your nervous system enough. And if this conversation feels uncomfortable, like you don't know enough or you're so far behind everybody, don't worry. This is exactly where change happens for you. You can pick up an anatomy book, watch a video series. I talk to your students about their bodies. Really watch them as they move their bodies and notice what you see. And find trusted teachers and accounts, maybe on social media that will teach you. Just keep taking steps to be more informed. I hope that this episode sparks some deeper thought around why and knowledge of pain and its effects on your nervous system is so important. As a movement educator, I've added a link in the show notes for you to send me a quick text message about your thoughts on this episode or any other. I will know your phone number. It's just an addition to the platform I use that allows for this new and really easy way for you to communicate with. Me once you click on it, it will take you to your messages, but don't delete the code. That's how your message is going to get to me. And I would love to know your thoughts on this topic. If you can't tell already, I love diving into these conversations because there are so many important discussions to be had in the teaching world. You know that my goal is for you to love the yoga teaching life and allow it to be fulfilling and rewarding. The ability to take care of yourself while you care for so many of your students is important too. If you loved this episode, let me know, subscribe to the podcast. So you're always in the know when a new episode drops. And share it with another yoga teacher who you think would love to be in on these conversations. Thank you for helping to spread the word about this podcast. And if you've been taking notes in your journal, as you listened to these episodes, I'm so glad you are. And I'd love to hear about it. Don't forget to download the ebook sequencing for different injuries. The link is in the show notes below. I promise you it will help you to form a foundation for teaching students with injuries. And it'll be a great resource for you to return to again and again. When you download the ebook, you'll be joining my newsletter. That's just for yoga teachers. I've got more exciting teachings coming soon. So I want to tell you all about them, but link is in the show notes below, and I would love for you to join it so we can always stay connected. All right. That's it for now. Bye.

29:30

Mhm.