Orchestra in the brain 

One concept I found helpful and interesting from the Explain Pain book I’ve written about before is the “orchestra in the brain.”

With chronic pain, the brain starts to play the pain “tune” over and over. It gets really good at it. The book says, “It is like the orchestra in your brain has been playing the same pain tune over and over… it can no longer play a full repertoire of tunes. Nor can it be creative, curious, or seek new musical challenges… You get the picture: the pain starts to dominate every aspect of life.” I read this and felt like it was speaking directly to me.

And, as a result of this pain tune playing all the time, my world and experiences have gotten smaller. I go out and do ONE thing a day and the rest of the time I spend at home. I have a much slower paced lifestyle than I used to and much less sensory input. At the same time, I am sensitized to pain and sensory input much more.

I’ve been recognizing that new sensations can seem overwhelming. I slept in a bed at someone’s house recently and I noticed the sheets felt so different from mine, almost uncomfortably so. I don’t think I would have noticed things like this before. Also, yesterday I was at a wonderful bridal shower and while I was so glad to be a part of it, it was overwhelming in a lot of ways. I was hyperaware that everyone was talking over each other as different groups had different conversations, all over the conversations at the restaurant. The colors of the decorations and everyone’s outfits were a lot to look at. I also had high pain levels because of the walking and probably also because I was overwhelmed. Sometimes when I’m in a “normal” social situation where there’s a lot going on, I feel like I’ve been in a sensory deprivation tank and there is so much for my senses to process!

I came home from the party and laid down and meditated, watching my breathing, for a long time to calm my system down and feel a “comfortable” level of sensory input.

In chronic pain, our nervous systems get sensitized not just to pain, but to everything! I’ve been learning that slow, paced exposure is important to help open myself up again and desensitize my nervous system. During this exposure I have to pay attention to my limitations and pain level, so the experiences doesn’t backfire and result in a lot of pain, with a feeling “I’ll never do that again.”

The Explain Pain book says we have to practice getting our brain to play all the tunes of the orchestra again. The book says, “We would like to remind you that your brain with its billions of neurones and trillions of everchanging connections has vastly greater capacities and abilities than just making pain.”

One small thing I’ve been thinking of is trying to get used to wearing different shoes. I wear two pairs of shoes only, both of which are extremely comfortable and have good arch support. I have a few other pairs of shoes which are cuter, but I never wear them because if I think about something new on my feet, I assume it will contribute to pain. These cute pair of shoes I’m talking about might not be as comfy running shoes, but they’re still pretty sensible by normal standards, and I have insoles I could try in them. Another thing my physical therapist has recommended is listening to music as I do standing exercises or anything standing, which might help me from simply focusing on the pain and get used to more sensory input. I’ll try these things as my homework. I’ll also start thinking about things I can do to help build the repertoire of the orchestra in my brain again.



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