Control Pain & Heal Faster With Your Brain | Huberman Lab

Key Takeaways

  • Inflammation has a bad reputation but an immediate, acute inflammation response is good and allows the body to repair tissue
  • Chronic, unchecked inflammation is bad
  • Neuroplasticity allows our nervous system to change itself in response to experience which impacts how we experience pain
  • Pain is complex because there is a subjective component
  • “Pain is a belief system about what you’re experiencing in your body.” – Dr. Andrew Huberman
  • Visualization exercises using imagery to imagine the amputated limb have been shown to reduce phantom limb pain
  • To overcome motor injury: restrict use of the uninjured limb and force (within reason and safety) use of an injured limb
  • The glymphatic system is key in clearing out debris that surrounds injured neurons in traumatic brain injury
  • To better activate the glymphatic system: (1) sleep on the side instead of stomach or back; (2) sleep with feet slightly elevated; (3) 30-45 minutes of Zone 2 exercise 3x/week
  • Key components of injury/tissue rehabilitation: sleep, short walk, heat more than ice, sunlight

Introduction

Dr. Andrew Huberman, Ph.D. is a Professor of Neurobiology and Ophthalmology at Stanford University School of Medicine. His lab focuses on neural regeneration, neuroplasticity, and brain states such as stress, focus, fear, and optimal performance.

In this episode of Huberman Lab, Dr. Huberman takes a deep dive into the science of pain, the mechanism by which it arises in the body and brain, and how we can control our experience of pain. Dr. Huberman also discusses phantom limb pain, traumatic brain injury, and acupuncture.

Host: Andrew Huberman (@hubermanlab)

Somatosensory System

  • Neuroplasticity allows our nervous system to change itself in response to experience
  • Somatosensory system: system involved in understanding touch and physical feeling on the body
  • Sensors that reside in skin and deeper layers respond to mechanical touch, heat, cold, vibration, etc.
  • Receptors send information via axons down spinal cord and to the brain

Controversy Of Pain In Neuroscience

  • Pain has a physical and mental component
  • Pain has a perceptual component – “pain is a belief system about what you’re experiencing in your body.” – Dr. Andrew Huberman
  • Nociception: physiological term which describes the mechanism without the emotional component 
  • Understanding pain offers systems we can leverage to understand the difference between pain and injury 
  • There can tissue damage (e.g. radiation, x-rays) without physical sensation of pain
  • There can be pain without tissue damage – visual image of something we perceive as painful can give feeling of pain
  • Pain has some genetic component and some adaptive role
  • Plasticity of perception has significant impact on emotion pain and trauma

Subjective Aspect Of Pain Modulation

  • The pain system is subject to perceptual influences
  • Our interpretation of an event is powerful dictating our experience of the event
  • Adrenaline blunts experience of pain
  • People who anticipate an injection of morphine report reduced pain because they know the relief is coming
  • Feeling of love, infatuation, obsession – internally blunts pain response possibly because of dopamine release
  • Looking at an image of a loved one allows people to reduce pain response and raises threshold for pain  

Homunculus

  • Homunculus is a representation of the body surface which is scaled in a way that matches the sensitivity
  • Homunculus shows the size of brain area as related to density of receptors, not physical area
  • Areas of the body with more dense receptors will be more sensitive to pain than others
  • More receptors = more blood vessels and glia that respond to inflammation

Phantom Limb Pain

  • Phantom limb pain: sensation of removed/amputated limb in the position it was at the time of trauma
  • Representation of hand is intact in the cortex and it’s trying to make sense of proprioceptive feedback
  • Potential treatment: use the mind to control the perception of what’s happening in the body
  • Mirror box visualization exercise: place intact limb in a box with mirrors and visualize opposite (removed) limb to remap brain’s image of body surface
  • Patients who performed mirror box visualization reported immediate relief of pain

Overcoming Motor Injury

  • Atrophy happens because nerves sending signals to muscles are inactive so muscles don’t contract
  • If there’s damage to sensory-motor pathways or limb, there’s a benefit to restricting the use of an uninjured limb
  • Restrict movement of intact, uninjured limb to force some movement in injured limb and increase plasticity in the brain
  • Imbalances between the right and left body quickly become exaggerated if use is restricted
  • Senses and movement are competing for space in the brain so we need to respect the competition
  • Encourage activity of injured limb, as much as possible without pain or further injury
  • Recovery is faster in patients who restrict the use of uninjured limb and safe use of an injured limb
  • Examples: in a shoulder injury perform some reaches, with a knee injury gently ride a stationary bike to equally work both sides

Traumatic Brain Injury (TBI)

  • TBI can cause general degradation of brain function
  • Symptoms of TBI: headache, photophobia, mood changes, sleep disruption
  • The brain has a heightened capacity for repairing itself earlier in life versus later
  • Try to avoid a second TBI if you have had one
  • The glymphatic system in the brain clears out debris that surrounds injured neurons
  • Most activity of glymphatic system happens during the earlier part of the night during slow wave sleep
  • Two methods of glymphatic system activation: (1) sleeping on the side instead of back or stomach; (2) sleep with feet slightly elevated
  • Exercise for improved glymphatic system function: zone 2 cardio (low-level cardio) like a light jog, walk, an easy bike ride – 30-45 minutes 3x per week

Acupuncture & Inflammation

  • Acupuncture uses needles to stimulate electricity in the body
  • Acupuncture illuminates cross-talk between the somatosensory system and autonomic nervous system
  • Acupuncture can modulate pain and inflammation but there has to be a systematic understanding of the effect you are trying to achieve
  • Certain patterns of intense stimulation of the abdomen can liberate immune cells and counter infection
  • Stimulation of feet and hands at low intensity can reduce inflammation
  • There are real maps of our body surface that interact with our molecules and stimulate or reduce inflammation, blunt response to pain, increase (good) inflammation
  • Not all inflammation is bad: inflammation is a tissue repair response – it calls cells to the site of injury to treat
  • Inflammation has a negative connotation because unchecked or chronic inflammation is bad

Directing Plasticity Toward Specific Outcomes 

  • Wim Hof breathing and ice baths release adrenaline and can counter infection but you want to dose and regulate the release
  • Adrenaline and inflammation is adaptive at the moment
  • Short term plasticity can make us better able to cope with an acute event

Necessities For Injury/Tissue Rehabilitation

  • Sleep is essential – 8 hours of sleep or at least 8 hours immobile
  • Walk 10-min per day unless it exacerbates the injury
  • Ice numbs the environment of injury and has a placebo effect but also has negative effects that may offset the use
  • Ice can restrict movement out of the injury site
  • Heat can improve the viscosity of tissues and improve blood and damage out of the area
  • Sunlight may be as effective as red light

Platelet Rich Plasma (PRP), Stem Cells, & Baby Blood

  • PRP has never been shown to have an effect itself
  • The number of stem cells in PRP is minimal
  • Stem cell technology is on the horizon but needs much more research
  • The concern is stem cells can become a number of things so it’s difficult to know the safety for a specified area
  • Blood from umbilical cords has been shown to vitalize brain tissue in mice
  • It’s possible that young blood may be used to treat neurological pathologies in the future
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Notes By Maryann

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