explain
pain
section
4
page
78
Orchestral changes
We can use themetaphor of the brain as an orchestra to
make sense of the brain changes that we’ve been talking
about, for instance those brain changes that occur as pain
becomes chronic. It is like the orchestra in your brain has
been playing the same pain tune over and over and over
and over… It can no longer play a full repertoire of tunes.
Nor can it be creative, curious or seek newmusical
challenges. Keymusicians quit because they have nothing to
play. Othermusicians become tired and sick because they
play all the time. Somemusicians take over others’ roles,
for example the trumpeters take over the violinist’s part.
The pain tune is not a happy tune and it’s the same tune
again and again (we all get songs stuck in our heads from
time to time). Tours get cancelled as the orchestra stays
home. Audiences stop coming. Record sales drop. iTunes
downloads dry up. You get the picture: the pain starts to
dominate every aspect of life – work, friendships, family life,
hobbies, thoughts, sports, emotions, devotions and beliefs.
Although painmay completely take you over, we would like
to remind you that your brainwith its billions of neurones
and trillions of everchanging connections has vastly greater
capacities and abilities than just making pain.
It is important to emphasise here, that when the brain is
sensitised, it is not just the experience of pain that is
persistently produced. It also draws in other protective
systems such as the sympathetic nervous system (making
you aware and vigilant), endocrine system (transports
energy tomuscles, speeds up digestion) and themotor
system (the longmuscles like your hamstrings are ‘turned
on’ and ready to run). These systems and others can feed
back into the brain and combine to perpetuate the pain
tune, whichwe have also called the ‘pain neurotag’.
Changes in these systems are discussed later in this section.
The orchestra plays the pain tune
