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Survival of the Safest: The protective nervous system. Part 2

Why does our body develop chronic pain, chronic fatigue and anxiety?

First, let’s recap. In Part 1 of this series, I talked about pain and fatigue as protective mechanisms.

We are genetically wired for survival as our number one priority. Happiness and comfort come a distant second. The more we are exposed to threat – or even just perceive a threat – the more sensitive our protective mechanisms become. The threshold lowers.

This is a function of neuroplasticity. Neuroplasticity, put simply, is the brain’s ability to change itself.

Here are some positive examples of neuroplasticity in action:

  • London cab drivers display significant growth in a part of the brain called the hippocampus, which is the memory center of the brain. As they learn the thousands of streets around London throughout their career, the hippocampus enlarges and these drivers display remarkable powers of map recollection.
  • Learning to ride a bike. Training strengthens connections in the visual, sensory and motor cortexes of the brain, which are responsible for these reactions and movements.

And some negative examples:

  • Soldiers exposed to danger and trauma may develop PTSD. The more severe, the more likely post-traumatic stress will occur. The amygdala, the brain’s main fear centre, demonstrates increased activity in people with PTSD
  • Children raised in threatening/dangerous environments are more likely to have developed sensitised and protective nervous systems as an adult (presenting in a variety of mental and physical health problems). Again, the amygdala (and other limbic system structures) are likely overactive.
  • Addictions/habits. Expectations of chemical rewards can be programmed into our brain.

Let’s get back to chronic pain, chronic fatigue and other weird, persistent responses.

Why do people in relatively safe environments, seemingly without traumatic history, develop these conditions?

If we can accept that these conditions are manifestations of exaggerated protective responses, we can begin to understand how they may come about.

Homo Sapiens have been around for over 150,000 years. But think how much our environments and culture have changed in just 200 years. In 1817, we did not even have steam trains. Just over 150 year later, we put a man on the moon. Nowadays most of us spend the majority of our day seated and looking at screens. So much change, with so little time for humans to adapt.

Although, the Sabre-tooth tiger, food and shelter are no longer our biggest concerns, there are so many more environmental, occupational, social and financial stressors that our brains may perceive as threats. And as I’ve noted already, the mere perception of threat can trigger as big a protective response as a live and present danger.

I have noticed that when I see a magpie flying near me I automatically flinch. This is not just because they are the mascot for an evil football team, but mostly, I realize in hindsight, because I have been swooped several times cycling. My brain has physically changed to react more protectively when I see these savage beasts!

Mass media, marketing and advertising set both conscious and unconscious expectations for us that we can never live up to. Therefore, our perception of ourselves may always be under threat in terms of body image, material wealth and social status. In daily life, most of us are simply unaware of the subtle stimuli that may be setting off danger signals in our subconscious minds and causing our protective mechanisms to kick in.

With the onset of pain, anxiety or fatigue, the background accumulation of such threat response could play a part.

These chronic responses in the body are physically real and genuinely debilitating. They are no one’s fault. Episodes may have an overt trigger (trauma, injury, stress or illness) or manifest without apparent cause.

Our understanding of the immune system is increasingly pointing to its importance in stress and protective responses. 70-90% of the cells in the brain are called glial cells. These are immune cells!

Chronic pain and chronic fatigue are likely to strongly involve hyperactivity of immune responses. Viral infections often seem to trigger the onset of chronic fatigue syndrome, and sometimes even chronic pain. But the same goes for physical traumas and psychological stresses.

However, I believe this immune connection will become clearer in coming years. Hopefully this will shed light on the countless, enigmatic auto-immune diseases, like lupus, rheumatoid arthritis, ankylosing spondylitis, coeliac disease and type 1 diabetes.

When trying to understand an individual’s chronic pain or fatigue, getting their whole story is vital. Trying to identify some of the pieces to their puzzle that we can change or understand, whilst knowing that there will be genetic, hormonal, and immune idiosyncrasies that we cannot fully comprehend, or change.

Nonetheless, there is hope. Becoming aware of subtle threat perceptions and reframing how we see these chronic conditions form the foundation for an effective approach to treatment.

So how do we use neuroplasticity to reverse these unhelpful conditions? Stay tuned for part 3!

Frequently Asked Questions

Osteopaths are primary healthcare providers which means that no referral is necessary. If your treatment is being covered by WorkSafe, TAC or DVA, you will require a referral to ensure that your costs are covered.

We are able to treat WorkSafe, TAC, EPC and DVA patients, however you will require a referral from your GP. For TAC and WorkSafe patients we will also require your claim number and date of injury.

We are covered by private health funds via extras cover. Exact details will vary depending on the individual fund and level of cover. We do have a Hicaps machine which enables you to claim health fund payments on the spot.

For medicare rebates you must qualify for an EPC plan. You will need to discuss this with your GP, and a referral is necessary.

Yes, please bring in any X-ray, CT or MRI scan results you may have. If you have a report for these scans, make sure you bring this along as well.

During your first consultation your osteopath will ask questions about your problem and symptoms. They may also ask questions about your medical history, any medications you are taking or other factors that may not appear to be directly related to your problem. If your medical condition changes during the course of your osteopathic treatment, you should tell your osteopath.

Your osteopath may ask about any recent X-rays, scans or test results that you may have.

Depending on the area of your body requiring treatment, your osteopath may ask you to undress to your underwear. It’s important that you feel comfortable, so you may want to wear loose pants or bring a pair of shorts to change into.

Next, your osteopath will conduct a full osteopathic examination and if necessary, clinical tests. This may involve diagnostic, orthopaedic or neurological tests, postural assessments and activities or exercises, which will help determine how best to manage your condition.

The examination may include passive and active movements, such as the osteopath lifting your arms or legs. As part of the examination, you may also be asked to bend over or stand in your underwear. Be sure to wear comfortable, flexible and appropriate underwear.

As osteopathy takes a holistic approach to treatment, your practitioner may look at other parts of your body, as well as the area that is troubling you. For example, if you have a sore knee, your osteopath may also look at your ankle, pelvis and back.

Your osteopath may also provide education and advice to help you manage your condition between treatments. This may include giving you exercises to do at home or work.

Osteopathy is a form of manual therapy, so hands-on treatment may include massage, stretching, repetitive movements, mobilisation and/or manipulation. Most osteopathic treatment is gentle and should not cause undue discomfort. If your injuries do require hands-on treatment of painful and tender areas, your osteopath will exercise care to make you as comfortable as possible.

Some people experience mild soreness for a day or two after treatment, similar to that felt after mild exercise. If this soreness persists or increases significantly, call your osteopath to discuss your concerns.

Your initial consultation may last up to one hour. This will enable your osteopath to take a thorough history, examine and treat you. Follow-up treatments are usually shorter. Depending on your condition, they can take 30-40 minutes.

Generally you would expect to see some changes in your symptoms after one or two visits; however, some long-term or chronic conditions may require a longer course or more frequent treatment. If you have any concerns, your osteopath will be happy to discuss these with you.

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