A Neuro-geometric Basis for Pain Management
It is well understood that muscle imbalances or dysfunctions have high corollaries to pain, joint erosion, and pathologies.1 I will introduce a newer and duplicatable pain treatment method called Brain-Body Calibration (BBC) and provide three examples at the end of this paper for clinicians to begin implementing this technique for patient pain relief. BBC is based primarily upon the intentional inducement of fractionated motion using newly discovered motion protocols called micro-exercises (MEs). MEs provide a basis to numerically evaluate cerebellar functional performance that heavily influences muscle and joint dynamics that have a bearing on non-cancer musculoskeletal pain. These same MEs simultaneously stimulate cerebellar learning thus effectively optimizing muscle tone, reducing pain and improving cognitive functions.
MEs have demonstrated effectiveness for both acute and chronic pain and having provided a noteworthy relief effect of a durable and lasting nature.2,3 MEs have also demonstrated to be effective for inflammation which implies an effect on the CNS. Similarly, BBC is effective on compression-based pathologies through direct relief of either the lack of muscle support or hyperactive musculature—both of which are known to cause collapse of joint spaces. Typically in musculoskeletal pain management, we utilize a “site-specific” perspective of muscle dysfunctions such as injury, spasm, trigger points, hypotonicity, imbalances, etc., and treat the body at the site where the pain is located—or referred from other points—with medication and a array of physical therapies. This paper explores muscle and joint pain from a “non-site-specific perspective” exploring the role of specific brain regions and functions in the development, maintenance and resolution of musculoskeletal pain.
There are other elemental observations of aberrant motion—such as angular vector of applied force—that reveal errors in cerebellar function. In the latter case, if the angular vector is less than or greater than 90 degrees to the axis of rotation, a failure in radial functional applied force is a further manifestation of fractionated motion. Although execution of anatomically-incorrect motion, end-range performance abnormalities and fractionation of motion all represent significant failure at the cerebellar level to maintain proper control of the motion envelope, only fractionation of motion is focused upon in this article.
Early in 2003, I noticed a curious phenomenon during the rehab of a dance patient with a four-year history of moderate-to-severe painful injuries to the hamstring muscles and upper tendon. MRI ruled out any tearing or ruptures even though scar tissue was visible and palpable. A tremor-like response of the entire leg under very light loads—particularly during eccentric active motion—caught my attention. Although fractionated motion is similar in appearance to muscle tremor, it does not stem from neuro-degenerative pathology. Instead, as I later discovered, the muscle tremor was likely caused by corrupted data pattern templates emanating from the cerebellum.4 Since we know that a primary function of the cerebellum is to smooth out motion, the emergence of fractionated or stuttered motion implies a decline in neural-cerebellar performance.5 This decline in brain performance can be measured creating a new “index of errors” of non-performance of the motor system propagated by the CNS. The correlation of musculoskeletal pain and eccentric fractionated motion has been shown to be extremely high in 264 documented cases. With smoothening of motion by way of the cerebellar controls over the motor system, pain abates in a clinically significant manner—both in timeliness and magnitude.
|Fractionation Magnitude||Kinetically observed calibration (felt in the hands of the practitioner) during one micro-exercise cycle—including one concentric followed by one eccentric movement||‘Index of Errors’ Value|
|Very Large||Characterized by sudden high static tension followed by collapse and loss of control, “stops in space”||-4|
|Large||Large stutters in motion but does not stop in space||-3|
|Medium||Moderate stutter deviations from smooth motion||-2|
|Velocity Variance||Variances in velocity comprised of acceleration and deceleration during movement—with or without fractionation||-1.5|
|Small||Slight stutter deviations from smooth motion||-1|
|Vibration||Kinesthetically felt as a vibration at approximately 15–20 cycles per second||-0.5|
|Index of Calibration|
-9 -8 -7 -6 -5 -4 -3 -2 -1 0 00 Target
|-7 is the average score for the first attempt of any micro-exercise (ME) motion. Expect improvement of 5 points, on average, (to -2) for the first of two calibrations one week apart. These metrics are derived from over half-a-million repetitions and represent approximately 4,000 hours of brain-body calibration experience.|
Successful calibration (index of ‘00’) is achieved when two consecutive repetitions under convincing power are smooth, crisp, initiate and finish strong—especially at end ranges of motion.
Because the cerebellum’s role in motion is smoothness and accuracy, errors in it’s functional definitions are revealed by stuttered (fractionated) motion, accelerations and decelerations and, occasionally, as either complete loss of strength or its opposite of a sudden, brief, hypertonic spastic freeze in motion.
Clinical observations of 264 patients—presenting with a variety of musculoskeletal pain symptoms and subjectively measured pain intensities using a VAS—found the following top three items commonly observed in a variety of limb, extremity, spinal segments and TMJ motions: