Neuroplasticity – what, why and how?
Neuroplasticity, brain plasticity or brain malleability is the brains ability to form new neural (nerve cell) connections throughout our life. Plasticity is a feature of neural tissue that allows it to change in response to its environment. This change can be to the nerve structure, function or chemical activity.
Video courtesy of Phil Parker, PhD
Neuroplasticity in action
Every time we learn something new, we create new connections within our brain. The more we practice and utilise this new skill, the stronger this connection becomes in our brain (forming a habit). When we use this new skill often, our ability to draw upon it becomes faster. This connection in our brain becomes more dominant and decreases the strength of other connections that are used less often (old pathways). Habits are well-travelled, frequently used pathways in our brain. Learn more about this here
Neurons that fire together, wire together (Donald Hebb, 1949)
Video courtesy of TED Talks with Dr Joe Dispenza
Neuroplasticity can lead to positive and negative changes within our brain. If we want to learn to be more optimistic or grateful, we can practice skills that enhance these connections in our brain e.g. gratitude journaling, reframing negative thought patterns, practice the 5 good for every 1 bad we see in people. By practising these skills on a daily basis, it can help shift the negative bias within our brain.
“Success is the sum of small daily efforts, repeated day in and day out” (Robert Collier)
Neuroplasticity means our brain is constantly learning, evolving and changing. The consequence of this is that whatever we repeat – thoughts, feeling, behaviours – will change the connections and structure of our brain. The challenge is, our brain cannot distinguish what is good or bad, helpful or unhelpful. Factors which can change our brain include traumatic events, chronic illness, chronic stress, social interactions, meditation and other relaxation activities, emotions, learning, paying attention, new experiences, diet and exercise.
Our ability to learn, allows us to change, evolve, adapt, critically think, analyse and move through our life. Strengthening commonly used thoughts and skills, allows us to access this information “freeway” quickly. It allows us to protect ourselves, use our strengths, master hobbies, access memories, strengthen relationships, progress in our work. It is part of what differentiates us from other living creatures.
Neuroplasticity and chronic pain
Some neuroplastic changes occur beneath our awareness and control. One such change is being studied widely in pain medicine and is known as sensitisation. This is a phenomenon associated with changes at the nervous tissue which amplifies pain signal transmission to the brain.
Our central nervous system includes our brain, spinal cord and nerves. Central Sensitisation is a condition in the nervous system responsible for the development and maintenance of chronic pain. Central Sensitisation occurs when the nervous system starts to adapt adversely to pain signals. This occurs after prolonged stimulation of the nociceptors (pain receptors) and leads to changes in how we process pain signals. The nervous system goes through a process known as “wind up” which includes high reactivity of our “warning system” to less stimulus (activities, sensations) and amplification of pain signals: the volume on pain is turned up and more pain is felt.
This increased sensitivity can also apply to other bodily processes:
- heighten sensitivity to odours, sensations, vision, sounds and taste
- increased emotional distress, anxiety, fear and stress
The two main characteristics of Central Sensitisation are:
- Alloydynia – things that hurt, now hurt more (learn more here)
- Hyperalgesia – things that didn’t hurt, now do (learn more here)
Changing the trajectory
There is ongoing research into how we can slow, halt and even potentially reverse the trajectory of central sensitisation. Dr Moskowitz author of the “Neuroplastic Transformation – Your Brain on Pain” describes how there are 16 areas in our brain that “light up” when we experience pain. There are 9 areas located in the conscious part of our brain (the cerebral cortex) that dedicate roughly 5% of nerve cells to process pain, this increases to 15-25% in chronic pain. Chronic pain spreads the areas of the brain that concentrate on pain; increasing pain’s significance and importance. What Dr Moskowitz has learnt from his study into pain, is that strengthening the function of these “pain” areas within the brain with other functions (not pain), will strengthen the importance of “non-pain” related functions, prioritising them over pain.
Other research article looking at neuroplasticity and pain includes:
- Chronic pain: The role of learning and brain plasticity (link)
- Neuroplasticity and pain: what does it all mean? (link)
- Neuroplasticity and Healthy Lifestyle: How Can We Understand This Relationship? (link)Pain and the brain: specificity and plasticity of the brain in clinical chronic pain (link)
- Maladaptive plasticity, memory for pain and phantom limb pain: review and suggestions for new therapies (link)
- Baseline Brain Activity Predicts Response to Neuromodulatory Pain Treatment (link)
- Cognitive behavioral therapy increases prefrontal cortex gray matter in patients with chronic pain (link)
- Central sensitization: Implications for the diagnosis and treatment of pain (link)
- Increasing Neuroplasticity to Bolster Chronic Pain Treatment: A Role for Intermittent Fasting and Glucose Administration? (link)
Many of the activities involved in the active self-management of chronic pain are aimed at reclaiming “real-estate” in your brain from pain. These activities include: decision making, pleasure, planning, problem solving, autobiographical and emotional memories, self-soothing (self-compassion), sleep and diet, connection and engagement, empathy and physical activity. Neuroplastic exercises for changing pain, involve learning and practising new skills and strategies for managing pain. Repeating tools for thinking, acting and being different helps to “dampen” the pain pathways; changing pain and our brain’s relationship to pain over time. Read more about training your brain away from pain in this article.
Learn more about rewiring the brain:
- Article: Rewiring the Brain to Get Out of Pain: the Moskowitz Approach (link)
- Article: Why Learning About Pain Science Can Help Heal Chronic Pain (link)
- Article: How CBT Can Help You Manage Chronic Pain Symptoms (link)
- Article: What Is Graded Exposure Therapy and How Can It Help Chronic Pain? (link)
- Article: What is Graded Motor Imagery and How Can It Help Treat Chronic Pain? (link)
- Article: What is biofeedback and how can it treat chronic pain? (link)
- Article: Train Your Brain Away From Chronic Pain – The Complete Guide (link)
- Article: Mindfulness For Chronic Pain: A Comprehensive Guide (link)
- Article: Pain Management: All Your Self-Help Options (link)
- Article: Exercise With Chronic Pain: Your Complete Guide (link)
Tools for changing the brain and pain:
- Graded Motor Imagery (link)
- Moskowitz Exercises (link)
- Guided Imagery for Pain (link)
- Mindfulness Practice (link)
- Physical Exercise (link), Tai Chi 18 Moves video, Yoga video
- Gratitude Meditation (link), Gratitude Exercises (link)
- Forgiving yourself meditation (link), Exploring self-compassion through writing exercise (link)
- Self-Compassion Guided Meditations:
- Changing your critical self-talk exercise (link)
- Identifying what we really want exercise (link)
- This Way Up Online Courses (stress management, managing insomnia, mindfulness) (link)
- Mindfulness Stress Reduction Information and Resources (link)
- Stress Management Tools (link)
- Article: ICP: Catastrophising and Chronic Pain (link)
- Article: ICP: Fear-Avoidance of Pain (link)
- Article: ICP: The Perfectionist and Chronic Pain: How to Cope with Pain Series (link)
- Article: ICP: All or Nothing Thinking: How to Cope with Pain Series (link)
- Article: ICP: Reducing Pain Behaviours: Coping with Pain Series (link)
- Article: ICP: Reducing Pain Talk: Coping with Pain Series (link)
- IASP Webinar: Why, what and how of nutrition for people experiencing chronic pain (link)
- Tools for a better quality sleep (link here)
- Tools for planning your day (link here)
- Tools for goal setting (link here)
- Tools for introducing pacing into your day (link here)
- Tools for managing flares (link here)