TMS, Neuroplastic Pain, and Mindbody Syndrome are essentially different names for the same thing. TMS is the term created by John E. Sarno while the other terms have been commonly used by other practitioners. To understand neuroplastic pain, it is important to first understand what general pain is.
Types of Pain
Pain, put simply, is a perceived danger communicated from the body to the brain in response to a stimulus. For example, if you are on a run and break your ankle, the pain will do its job and communicate with your body not to keep running and risk further injury. Generally, receptors in the body communicate with the brain to keep us safe.
Pain can be categorized into the following:
- Acute pain: pain that resulted from a recent injury. Usually lasts days to weeks.
- Chronic pain: pain that has continued past the normal period of healing (usually around 3-6 months.
- Nociceptive pain is pain that originates from actual tissue damage
- Neuropathic pain is pain that results from damage to nerves.
Neuroplastic Pain/ TMS
Neuroplastic pain is different from the other types of pain in that it is not associated with actual structural damage. It develops when the brain makes a mistake and perceives an injury when there is none or when pain persists after the initial injury has healed. Neuroplastic pain is the perception of danger (or damage to the body) and not an actual danger that causes pain.
One famous example of neuroplastic pain is the story of a construction worker who got injured on the job (Fisher et al, 1995). While working, the worker jumped onto a plank and a 7-inch nail pierced all the way through the bottom of his boot and protruded out of the top of the boot. When he looked down and saw the protruding nail, he was in excruciating pain. He was quickly taken to the ER at which point the doctor took off the boot and found that the nail had gone in between two of his toes. He had no structural injury yet felt an extreme amount of pain! In this situation, his brain had perceived the nail, misjudged that there must be damage, and produced a very real pain.
Personally, I have had the opposite happen to me. I remember one day running early in the morning when it was still dark with my high school cross country team. We were running through an intersection that was still under construction and I tripped and fell on my knee. The group I was with did not notice that I had fallen and I felt fine so I just got up and kept running.
It wasn’t until we got back to the school and the sun had begun to rise that someone pointed out that I was bleeding. I looked down at my knee and saw a fairly large gash on one of my knees as well as cuts down both of my legs. It was at this point that I finally felt pain. Even though the injury had occurred at least 30 minutes before, I had been enjoying my run and didn’t feel the pain until my brain realized that there was damage.
Both of these examples show that the brain, although generally good at its job, can make mistakes.
Neuroplastic pain can also come on because of a general state of fear or an overstimulated sympathetic nervous system response (the branch of the nervous system responsible for protecting us from imminent danger). There doesn’t have to necessarily be a perceived initial injury. The pain may be a response to fear and fear can cause the pain to perpetuate.
This stress can either be caused by a stressful situation (either happy or sad) or could be brought on because of general stress in a person’s life. This is why people who have certain personality characteristics such as conscientiousness, people-pleasing, or anxiousness have a higher chance of developing neuroplastic pain as well as those who have experienced childhood trauma. When the brain is already on high alert, as it is in times of stress, it is more likely to mistake safe signals in the body as dangerous.
Signs Chronic Pain is Neuroplastic
How To Treat Neuroplastic Pain
Because neuroplastic pain originates in the brain, not the body, the treatment must target the brain. Treatment can include education in the neuroscience of pain, journaling, mindfulness exercises, and, in cases of unresolved trauma, psychotherapy. The most important thing that all of these treatments target is the fear surrounding pain. Fear is what is causing the brain to be kept in a high-alert state and perpetuates the pain.
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References: Fisher JP, Hassan DT, O’Connor N. Minerva. BMJ. 1995 Jan 7;310(70).