It’s All in Your Head: The Neurological Connection of Brain to Pain (By Marissa Thomson, BScHK)1/30/2019  Schematic diagram of pathways involved in pain transmission and modulation. Pain is one of the most common medical complaints that drives individuals to seek professional assistance. Although searching for a cause is a priority, when one can’t be identified it is not uncommon for doctors to say “it’s all in your head.”
When excruciating pain is labelled as mental fabrication it can leave a person feeling misunderstood, isolated, hopeless and full of frustration. If you or anyone you know has encountered this situation then read on because there is more to your pain than imagination! Lorimer Moseley, a professor of clinical neuroscience at the University of South Australia, has developed a theory to explain the connections between pain, the mind’s potential to change it. When thinking about this theory it’s important to take a look at the basic physiological pathway of pain sensation (see figure): Nociceptors (pain receptors) → Spinal Cord → Brain (perception occurs) → Physical response Moseley’s theory proposes that the experience of pain depends on the neural connections made during an individual’s previous experiences. When an event occurs, the nociceptors (sensory nerve endings that perceive pain) relay the information to the brain where the determination of danger or safety is decided. If the brain deems a situation as ‘safe’ there will be no experience of pain. However, when the brain has had a previous history of trauma, danger, or harm it will release ‘danger’ signal often resulting in a physical sensation of pain. Moseley’s view is that the experience of pain is dependent on whether the brain thinks danger exists or not. The experience of pain can become more severe if it has been persistent over a longer period of time. Moseley’s thought is that although the initial sensation is sent to one region of the brain, with extended duration the signal may spread to adjacent areas. The increase in neural stimulation can lead to the brain believing the body’s condition is worsening or that the pain has enveloped additional body parts. In actuality the body may be physically sound and the pain is more a product of what the brain thinks is occurring. This would suggest that pain originating in the mind doesn’t not exist, but simply can’t be explained through physical tests. Instead, these types of clinical scenarios require the unpacking of psychological traumas and a rerouting of neural circuits. There are many other theories regarding the connection of body and mind that have been supported by scientific research. One in particular to note is the significant improvements seen in fibromyalgia patients with the use of ‘Emotion Awareness and Expression Therapy’ (EAET) which involves the targeting of mental and emotional experiences, both positive and negative. The process allows individuals to work through their past and towards rewiring thought patterns and neural pathways. One study found that EAET alleviates symptoms such as globalized pain, physical dysfunction, anxiety, stress, and improves overall life satisfaction. Understanding that there is a connection between the body and mind opens up many additional approaches to pain management, and holds potential in reducing the burden of chronic pain. If you’ve been told “it’s all in your head,” take it to heart and talk to a naturopathic doctor or other healthcare provider about addressing your pain through your brain.
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 As the cold weather settles, we turn to staying indoors more often. While embracing the coziness of the season can be rewarding and fun, it’s important to remember the benefit nature has on our mood and stress response!
"Forest bathing" is a Japanese term for walking in nature and has been extensively studied for its benefit in improving mood, ability to meditate, and even blood pressure and cardiovascular outcomes (1, 2). The principle is simple: it involves putting your phone away, taking walks in nature and mindfully connecting and paying attention to your surroundings. An easy way to do this is to consciously go through your 5 senses and name one thing you are experiencing. What are you seeing? What are you hearing, feeling (wind, cold, snowflakes), what can you touch? and what can you smell? This practice helps ground you in the moment and drive home the connection with your surroundings. While this practice has been researched in heavily wooded areas, this practice of noting the natural elements around us can help shift our perspective and demonstrate how much nature we are surrounded by even within an urban environment. In addition to being mindful of nature and our environment, there are a few other ways we can incorporate nature and the winter season into our routine, especially when living in an urban environment. This can be as simple as walking to work, or getting off a stop earlier on our commute in order to have some added time outside. Another thing to keep in mind is to bundle up! It’s never as cold as you think when you have the appropriate winter wear on. Instead of meeting a friend for a coffee and staying at the coffee shop, try grabbing one to go (bring your re-usable mug!) and catching up via a walk. It’s an easy way to sneak a little nature, exercise and sunshine into your social life! In Toronto, seeking out a variety of different trails and parks can be helpful when trying to escape the busy city. Some of my favourite places to enjoy in the core of the city to enjoy what nature has to offer are the following: Allan Gardens Walking among the variety of plants can really make you feel like you are in a tropical oasis! It’s very refreshing to feel the warmth of the green house and be enclosed with all the smells of the exotic plants and trees. High Park This list wouldn’t be complete without including all the great nature to be found at High Park. Accessible by TTC, it can be great to get out and walk around the various areas of the park to connect with the trees and plants. Courtyards at the University of Toronto The university has some beautiful and hidden courtyards that are usually accessible during the week. Some of my favourites include the Hart House Quad, Trinity Quad, and University College Quad. Other great green spaces at the university include the Philosopher's walk path and Queens Park. Harbourfront The Harbourfront is another great space to enjoy nature and gain some space from the city. Walking or running along the path in the winter provides a different perspective of the water! Skating With the start of the cold weather, we have the opportunity to take part in skating all over the city! There are lots of different spots including skating in front of the Toronto sign at Nathan Phillips Square or Harbourfront. While this list is not exhaustive, it contains some ideas to stay connected to nature while living in the city! Other great ways include taking a road trip further out of the city to explore more extensive trails or parks, or really get into the season by participating in some winter sports such as skiing, snowboarding or snowshoeing! References
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