Thursday, August 2, 2012

Musculoskeletal Injury, thinking and emotions

The specialist field of Neuropsychology is involved in the diagnosis of disorders of cognition (roughly thinking and emotions)
In the past few years there has been a surprising overlap between this field and musculoskeletal disorders.
It is not immediately apparent to relate the two, after all although the body has a brain science has considered thinking and physical movement to be two separate and distinct brain processes.
However for years practitioners in various fields have noted the common presentations of learning and behavioural disorders coupled with motor or movement dysfunction.  Even in apparently normal cases it's common to observe how musculoskeletal problems appear to interfere with judgement, decision making, alertness and emotional control.  In fact not only can patients report pain but will perform poorly at tasks which test accuracy of movement and balance, aspects of human function which display not only limb movement but how well the brain is perceiving and controlling it.

Many of us are fully aware that it is difficult to concentrate when you have pain but what is the reason?  Is it just a distraction or is it more complex?

The brain is currently the most complex structure in the universe.  Not only do it's cells and connections create an almost infinite number of patterns but it changes from second to second in response to whatever is going on in and around you.  And it does it without 'you'.

Technically you only have pain when the signal from a damaged or potentially damaged part reaches the brain.  The brain then filters the signal based on innate responses which are continually being modified by past experience (basically good, bad, don't care).  This signal then goes to more complex cognition centers for further 'evaluation'.  Most of these processes are also not consciously controlled. 

In short although the underlying causes are not completely understood, it appears that physical injury or dysfunction may inhibit other more complex brain functions.  Head and neck pain sufferers often report feeling 'dull', 'muzzy' or 'off' in conjunction with their presenting complaint.  In particular those who also demonstrate poor postural control appear more affected.

Thanks for reading.

Regards  DS

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