Joint inflammation and muscular imbalance are a corner stone feature in those persons who consult with a Chiropractor, and factors that have long been associated with inflammatory arthritis. Conditions Chiropractors are not permitted, by their Regulator, to say they can help. Recent work into the specific inflammation of knee joints uncovered a surprising connection to particular brain activity feeds. Whilst feeding my Gastro Intestinal system may be an easy to grasp concept, feeding my brain sensory information may be a harder concept to swallow. However, the brain is fed by sensory experiences.
In the last 3 years research has shown that the way a brain is fed, also known as brain stimulus, can impact joint health. The sensory information fed to your brain from your body via the spine can impact joint inflammation. What you read, watch, hear, smell, taste touch etc (any sense) affects the way your brain is stimulated. For some parts of the brain the way it is sense fed will alter its structure, and joint inflammation. For example the Vagus nerve has been found to be able to modulate joint inflammation in the knee on the opposite side of the body. The Vagus nerve sensations travel up through the spine and into a part of the brain called the Locus Coeruleus (LC) (1).
Thanks to such interesting brain research the meaning for me, as a Chiropractor, is that I am interested in muscles, joints and now the human brain..!! As this type of research continues, about brain stimulus via the conduit of the spine, we can see the impact on clinical reasoning. If the LC can suppress inflammation in the opposite side knee joint then deciding to have imaging (MR or X-Ray technology) can’t be a reliable way to always see the source of knee joint inflammation. And often images will fail to show anything that changes the clinical course of knee inflammation over and above that of the prognosis attached to OA.
In this day and age we might ask about contextual factors (2) rather than reach straight for imaging. But because brain research is complex and new the understanding that some have on the impact of the brain on our health is limited to an ‘all in your head’ notion. Essentially resulting in P being insulted by D! As we learn and share information like the LC function then we may disseminate knowledge that enables the context of situations such as attention, drowsiness, emotion and stress to be considered when a new inflammatory joint is presented in clinical practise. The way contextual factors connect to body inflammation can be tricky to see, especially when one is looking for trauma or defect. The goal for the clinician is to be able to highlight to their P that such factors are at play in their life and may account for even dramatic changes in their joint health. Hopefully without being insulted!!
It could be a non-physically damaging sensory brain feed that contributes to a self-limiting somatic experience.
- Gabriel Shimizu Bassi et al (2017) Modulation of experimental arthritis by vagal sensory and central brain stimulation. Brain Behaviour and Immunology Journal 64 330-343
- Ogdie A et al (2020) Use of PROMIS29 Across Inflammatory Arthritis: Score Distributions and Impact of Contextual Factors. Arthritis Rheumatol. 72 (suppl 10).