Ever heard your Chiropractor refer to your pain as possibly a result of ‘stiffness in your C2’, or perhaps your ‘L5 feels out’? An adjustment or two later and just like magic you seem to be moving better and ‘back in alignment’. But was your pain really from a bone or joint out of place? Chiropractic-style joint manipulations and adjustments are said to date back to cave men days and while the ‘application’ of adjustments has continued since then, the latest research suggests the best ‘explanation’ of how they actually work has shifted away from a mechanical model and more towards neuroplasticity and remapping our joints and muscles back to our brain.

You may be asking yourself what on earth do our joints have to do with our brain? Joints are where movement occurs between different parts of our body. When our joints move, the muscles that move and stabilise those joints change their length. Muscles send this length data to the brain, and the brain uses this data to determine the position and movement of the body and its joints by referencing it to a ‘map’ it’s created from previous movements. For example, if we asked you to close your eyes and touch your nose with your left index finger you’d be able to do this by relying on your internal models of your body known as brain maps. When life is going well and you move during your daily activities, work and exercise, then your brain maps are also exercised, they become clear and ‘high resolution’, so you know exactly where your body parts are and can move them in a fluid and stable manner. But when you move less and do less (eg vacation, injury, pain or too busy with work), then these brain maps are not exercised and they start to get blurry. Scientific research has shown us that brain maps begin to go blurry very fast if they aren’t exercised, and the more blurred the map is, the more pain we may feel. This constantly evolving nature of the brain is also known as neuroplasticity, it is very much a use it or lose it system.

Content and Image from research paper by Louw A, Farrell K, Barclay M. The effect of manual therapy and neuroplasticity education on chronic low back pain: a randomised clinical trial. J Manual and Manipul. Therapy 2017. 25(5): 227-234. 

The modern deskbound lifestyle can starve our brain of the regular sensory input it needs in order to be able to feel and control the movements of the body well. We tell patients not to sit for more than 30 minutes without getting up to move around as that’s how quickly the brain maps start to go blurry. So what is the best movement to do? Is there a ‘best’ exercise? If you only do one type of movement all the time, not only can it get a bit stale and boring but it can also bring on some repetitive stress, and the minute you try and do a new movement you may find yourself tweaking some part of your body that’s not quite used to that new movement. Variety is the spice of life, and doing a variety of movements throughout different planes of motion doesn’t just strengthen all the different muscles in your body, but it also strengthens the brain maps which sense and control these various movements. Having a brain and central nervous system that is more responsive to various situations, reduces your risk of pain and injury, and also boosts performance. Choose activities and exercises that you enjoy doing, and do them regularly. Make movements and exercise a habit, a part of your daily life that you can’t live without. If there’s a movement you haven’t tried in a while, tell your chiro, physio or health professional so they can gently assist you in the early stages while you build up your confidence. Another great tip that can help when trying new movements is to slow the pace right down. Slower movements are generally perceived as less threatening by our nervous system, so are much less likely to trigger a need to protect (aka pain).

Many patients still often mistakenly think pain means physical damage to our body’s tissues (eg our joints, cartilage, discs, tendons, nerves etc). However, we see people with tissue damage (eg an osteoarthritic knee) and no pain. We also see people with lots of pain but absolutely no tissue damage visible on imaging. Pain is not a marker of tissue damage. Pain is not an input to the brain (differentiating it from nociception). Pain is an output of the brain, an alarm, a protection system, which is an indicator of the brain’s perceived need to protect the body. It doesn’t matter if you have an injury or not, if the brain perceives a need to protect the body, it will bring on pain. When you avoid using certain parts of your body, yes your muscles and joints may weaken, but your brain’s understanding of what those muscles and joints are capable of doing also shrinks, leading to a perceived need to protect them so it brings on pain and stiffness. Furthermore, low usage leads to a reduced ability to activate the small intrinsic spinal stabiliser muscles, compromising fine motor control and a loss of fluidity of movement. Overactivation of the gross musculature leads to stiffness (protection). So next time your chiropractor palpates your spinal joints for stiffness, keep in mind that this stiffness indicates a lack of fine motor control and blurred brain maps for that body region.