Georgia Chiropractic Neurology Center

Brain Based Treatment for the 21st Century!

Written by Sophie Hose, DC, MS, DACNB, CCSP

A Silent Epidemic

Imagine waking up to a world where every touch, movement, or thought feels like it’s filtered through a haze of pain. For many, this is the reality of central pain syndromes (CPS). This condition doesn’t emerge overnight but is the culmination of untreated or mismanaged pain, amplified by the nervous system’s attempts to adapt and cope. Chiropractic neurology offers a unique perspective on this complex journey, highlighting pathways for prevention and intervention.

What is Central Pain?

Central pain arises from damage or dysfunction within the central nervous system (CNS), including the brain and spinal cord. Unlike peripheral pain, which originates from injury or inflammation in tissues, central pain results from disrupted neural processing. The pain can range from mild discomfort to debilitating sensations, often described as burning, aching, or electric shock-like. Central pain can occur following conditions such as stroke, multiple sclerosis, spinal cord injury, or even chronic pain conditions where central sensitization has developed.

Central pain syndromes represent a spectrum of disorders, each with unique challenges:

  • Post-Stroke Pain: Damage to sensory pathways in the brain after a stroke leads to persistent, often severe pain. Patients describe sensations such as burning or freezing that resist conventional pain treatments.
  • Multiple Sclerosis-Related Pain: In multiple sclerosis (MS), lesions in the CNS disrupt neural signaling, causing dysesthetic pain—a burning, aching discomfort commonly affecting the limbs.
  • Spinal Cord Injury Pain: CNS changes following spinal cord injury can result in neuropathic pain below the injury site, often described as stabbing or electric shock-like.
  • Fibromyalgia: Though classified as a central pain syndrome, fibromyalgia is distinct in its diffuse muscle pain and heightened sensitivity to touch, attributed to widespread central sensitization.
  • Complex Regional Pain Syndrome (CRPS): This chronic condition features severe pain, swelling, and changes in skin color and temperature, often following minor injuries.

Central Sensitization: The Amplification of Pain

Central sensitization is a phenomenon where the central nervous system becomes hyper-responsive, amplifying pain signals and creating an exaggerated pain experience. This process begins when prolonged pain or inflammation causes changes in the spinal cord and brain. Neurons in these regions become more excitable, while inhibitory mechanisms that normally dampen pain signals weaken. Over time, even non-painful stimuli, such as light touch or mild pressure, can trigger significant pain (allodynia). Additionally, stimuli that are typically painful can feel disproportionately severe (hyperalgesia).

Key mechanisms of central sensitization include:

  • Wind-Up Phenomenon: Repeated stimulation of pain pathways leads to increased sensitivity over time, much like a volume knob being turned up.
  • Neuroinflammation: Chronic pain triggers the release of pro-inflammatory chemicals in the CNS, further sensitizing neurons.
  • Synaptic Plasticity: Changes in the strength and structure of synaptic connections reinforce pain pathways, making them harder to “turn off.”

Conditions like fibromyalgia, chronic migraine, and complex regional pain syndrome are prime examples of central sensitization at work. Understanding this process is crucial for both diagnosis and treatment.

Pain as a Messenger Gone Rogue

Pain, at its core, is a messenger—a signal that something in the body requires attention. In acute cases, it serves its purpose effectively, triggering protective mechanisms. However, when pain becomes chronic, the nervous system may begin to adapt maladaptively. Prolonged pain can lead to changes in the brain and spinal cord, particularly in regions such as the thalamus and cortex, creating a state of hyper-responsiveness.

Chiropractic Neurology and the Nervous System

Chiropractic neurology approaches pain as a problem rooted in the brain and spinal cord’s processing systems. Unlike traditional chiropractic care, which focuses primarily on structural alignment, chiropractic neurology emphasizes functional neural pathways and their role in pain perception.

  • Neuroplasticity—The Brain’s Adaptability: Neuroplasticity is the nervous system’s ability to reorganize itself by forming new neural connections. While this adaptability enables healing, persistent pain can hijack the process, reinforcing pain circuits. Chiropractic neurologists use therapies like vestibular rehabilitation, eye movement exercises, and sensory integration to reshape maladaptive patterns.
  • Proprioception and Joint Health: Joints—especially those in the spine—play a critical role in sending sensory information to the brain. Dysfunctional joints can send distorted signals, contributing to central sensitization. Specific spinal adjustments, tailored to the patient’s neurological needs, can normalize sensory input, reducing pain.
  • Autonomic Nervous System (ANS) Balance: Chronic pain often disrupts the balance between the sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) branches of the ANS. Techniques like cranial nerve stimulation, diaphragmatic breathing, and heart rate variability training help recalibrate the ANS, mitigating pain and inflammation.

Addressing the Cycle Early

The progression from acute to chronic pain is often subtle, but early intervention can prevent central pain syndromes from taking hold. Chiropractic neurology emphasizes proactive, patient-centered care:

  1. Functional Neurological Assessments: Comprehensive evaluations assess sensory, motor, and cognitive functions to identify CNS dysfunctions. Tests might include balance assessments, reflex testing, and sensory mapping to localize areas of neural hypersensitivity.
  2. Multimodal Therapies: A combination of spinal adjustments, myofascial release, neuromuscular re-education, and neurofeedback offers a robust toolkit for addressing pain’s root causes. For example, patients with fibromyalgia may benefit from low-force adjustments alongside guided visual and sensory therapies.
  3. Movement as Medicine: Gentle, controlled exercises tailored to the patient’s abilities enhance proprioceptive input and reduce neural hypersensitivity. Techniques like graded motor imagery and mirror therapy can retrain the brain’s perception of movement and pain.
  4. Patient Education: Understanding the mechanisms of central pain empowers patients to take an active role in recovery. Chiropractic neurologists teach strategies for pain management, such as mindfulness, pacing activities, and avoiding triggers that amplify pain.
  5. Nutritional and Lifestyle Support: Inflammation fuels central sensitization. Antiinflammatory diets rich in omega-3 fatty acids, antioxidants, and magnesium can reduce systemic inflammation. Chiropractic neurologists often recommend tailored supplements and sleep hygiene protocols to optimize recovery.

A New Hope – Reclaiming Quality of Life

Central pain syndromes can feel like a life sentence, but they don’t have to be. Patients often experience profound improvements through chiropractic neurology’s integrative approach, which prioritizes function and resilience. Success stories include:

  • A stroke survivor regaining mobility and reducing post-stroke pain through tailored vestibular exercises and adjustments.
  • A fibromyalgia patient reporting reduced pain and improved sleep after implementing dietary changes, breathing exercises, and targeted therapies.
  • A spinal cord injury patient learning to manage neuropathic pain using neurofeedback and guided sensory retraining.

These examples highlight the transformative potential of addressing central pain syndromes holistically.

A Journey Worth Taking

Pain can feel like a cruel villain, robbing us of life’s simplest joys. Yet, with a deeper understanding of how it evolves and a commitment to addressing its root causes, healing is possible. Chiropractic neurology provides a beacon of hope, guiding patients on their journey from pain to recovery. By embracing neuroplasticity, recalibrating sensory inputs, and restoring balance to the nervous system, patients can reclaim their lives, moving from surviving to thriving.

If you or someone you love is suffering from pain, whether chronic or not, and you would like to learn how chiropractic neurology can help, contact the team at Georgia Chiropractic Neurology Center today. We look forward to hearing from you.

References 

  1. Woolf, C. J. (2011). Central sensitization: Implications for the diagnosis and treatment of pain. Pain, 152(Supplement), S2-S15.
  2. Latremoliere, A., & Woolf, C. J. (2009). Central sensitization: A generator of pain hypersensitivity by central neural plasticity. The Journal of Pain, 10(9), 895-926.
  3. Borsook, D., Maleki, N., Becerra, L., & McEwen, B. (2012). Understanding migraine through the lens of maladaptive stress responses: A model disease of central sensitization. Journal of Neuroscience, 32(22), 6737-6745.
  4. Apkarian, A. V., Hashmi, J. A., & Baliki, M. N. (2011). Pain and the brain: Specificity and plasticity of the brain in clinical chronic pain. Pain, 152(Supplement), S49-S64.