Of the three kinds of pain detailed in the last post, neurogenic pain is perhaps the least understood.  The data we have gleaned from neuroscience tells an interesting story about both the complexity and plasticity of the human brain.  The central nervous system is capable of a multitude of strange and unusual phenomena, from a mixing of senses (synesthesia), to the sensation of pain in an amputated limb (phantom limb syndrome).

What we do know about the brain has come about through very clever experiments and cutting-edge technology, such as functional MRI scans.  This research has given rise to the term neurocircuitry, denoting the interaction between different brain areas, allowing for a complex coupling of thoughts, emotions, and sensations.  This is how the smell of freshly-baked cookies can bring you right back to a childhood memory of Grandma’s kitchen.  This is also how traumas can lodge themselves deeply within our physical body, intertwining the emotional aspect of the event with the sensation of chronic and unremitting physical pain.  It appears the nervous system mediates these various aspects of consciousness – mind, body, and emotions, all united within the different aspects of the brain.


Furthermore, it seems the body can perpetuate an established physical pain to distract the self away from an emotional one.  This seems contradictory as mobility is key for survival, but severe emotional trauma can be far more debilitating, fracturing one’s personality and leaving them bereft of security.  Thus, many of us will limp along, getting by, without the will or support to confront deeply rooted emotional traumas or the neurogenic pathways created from them.


Neurogenic pain therefore requires a very different approach from soft tissue and structural interventions.  Where an uncomplicated acute injury will heal, a chronic one might linger, defying all manners of treatment.  In this case, we must liberate the brain from its engrained pattern, signaling it to rewire itself towards comfort and ease.


Two distinct therapies accomplish can this.  Both are derived from the theory of meridian pathways as developed by traditional Asian medicine.  The first is a specific style of acupuncture.  Distal style of acupuncture is a very effective means of treating pain whereby the area chosen for treatment is far away from the area affected.  The curious thing about the discovery and development of distal style acupuncture is how the treatment areas relate to the affected areas.  For example, right wrist pain is often treated by selecting tender points around the left ankle.  Similarly, left hip pain can be treated by needling anatomically analogous acupuncture points in the muscles of the right shoulder.  


This seems odd, though there is no denying the clinical effectiveness for those who have experienced it.  What is most curious are the cases of chronic pain that respond to this distal style of acupuncture after several other therapies have failed, including acupuncture applied locally to the painful area.  What I have come to surmise is that the distal style of acupuncture works by encouraging the deadening or dismantling of pain neurocircuits.


Research1,2 suggesting this effect is evidenced when a specific region of the brain lights up in an fMRI scan when acupuncture is applied to the foot just seconds prior.  Acupuncture therefore may be providing a strong enough stimulation to the peripheral nerves (in the limbs) with which to therapeutically access the sensory cortex of the brain.  This effect can be globalized when combined with affirmations or evoked memories that access the limbic system of the brain.  This concept is used extensively in the second type of therapy: meridian tapping. 


Meridian tapping is the generic name for a whole host of techniques under the discipline of energy psychology.  The specific technique that I use in the clinic is EFT (emotional freedom techniques) developed by Gary Craig.  Meridian tapping utilizes affirmations that draw the conscious mind to a troubling thought or emotion.  Once that feeling is acknowledged, the person uses their fingers to tap on specific acupuncture points that signal different areas of the brain.  Deceptively simple, meridian tapping can be amazingly effective in making a disconnect between a trauma and the body’s visceral reaction to it.  This is of critical importance considering so many of us go about our lives physiologically still connected to traumatic events.  Often the very thought of the trauma can increase our heart rate and turn our breathing shallow.


Another clinical pearl for the treatment of neurogenic pain is the avoidance of stimulants, of which caffeine is perhaps the most problematic.  Stimulants make any biological process more pronounced – if you have pain and take a stimulant, your pain will most surely be worse.  Of all the types of pain, neurogenic pain seems to be the most effected by stimulants.  It it like dumping gasoline on a brain that is already on fire. 


Why exactly the body stores pain and trauma in our nervous system is a mystery that has yet to be solved.  Thankfully, we do have reliable techniques that can address neurogenic pain and bring a downtrodden individual out of the depths of despair.  The first step is acknowledging that there may be more to your pain than what is on the surface.  Holistically taking stock of your total being – mind, body, and emotions – will yield the most effective therapies.


For more information on the science behind neurogenic pain, visit the website of Dr. David Hanscom.

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