Tuesday, April 2, 2013

Can we predict chronic spinal pain?

We're familiar with spine pain as a result of trauma but why do some people develop chronic spine pain well after initial injury and can we predict who those people will be BEFORE they get symptoms?  It appears we might be able to do that.

Studies indicate that some people develop errors in sensorimotor control following neck injury.  This is the way your brain has control over the body.  All body part locations and movements are perceived by the brain via the nerves which are embedded in the mechanical structures.  So it's clear that damage to a joint may damage these sensation detecting endings and deprive the brain of the information it requires to control movement.  The term 'sensorimotor deficit' encompasses the errors we observe and is not only due to damaged nerves but the ability of the brain to rewire itself 'wrong' (maladaptive plastic changes).

The presence of these errors can predict the development of chronic pain before it happens and interestingly some individuals can experience these errors without any obvious trauma (so called idiopathic neck pain (or pain of unknown origin)).

Our brain is involved with perceiving the world around us and making sure we safely navigate our way through it moment by moment.  Body sway, poor balance, joint movement inaccuracy, head tilt, joint clicking, jerky eye movement and even difficulty concentrating are all aspects of sensorimotor deficit and are predictors of the development of chronic spinal pain.  Furthermore stress and anxiety are both known to exacerbate and even be associated with such disorders of movement.

Why some individuals experience these cognitive disturbances is thought to be genetically influenced (as is most everything:)) but a quick look at how we are wired up reveals that our emotional responses are influenced by how 'stable' we are.

These 'higher' relationships are less predictable in part because the neurology is far more complex and interwoven once we venture into the brain proper.