I'll admit that my rabbit holes make it difficult for me to hop on here and post quick tidbits that I find interesting and how it may tie into other things before actually doing that, and then I want to be able to sum it all up and make it make sense and... well, that takes a lot longer than a quick tid-bit.
But I want to change that so let's start here. I've been researching pain for a bit - everything from the way Autistics sense pain to how the body senses pain to the physiology of chronic pain, and of course how this all relates back neurologically.
One slice of this pie that I'm FASCINATED with is that connective tissue seems to have more sensory nerve endings that muscle, so it's VERY possible that we can mistake connective tissue or fascia pain as muscular pain - one example is the low back. (And please don't get me started on the interoceptive nightmare this is - we already struggle to figure out which sensation is which and now we have to look at connective tissue versus muscle versus internal organs versus bones...? I'm tired....)
ANYWAY. One of research articles I've been using specifically looks at chronic low back pain to determine what type of nerves are present within connective tissue, and it's role in pain.
"As a first step to investigate the role of connective tissue innervation in the development of low back pain, we aimed to characterize the normal innervation of the connective tissues of the low back."There's a ton of data to sort through as someone who doesn't have a background in the pain receptor stuff, but from what I can gather thus far, we have different types of nociceptors - our pain receptors - which indicate a host of things I don't fully understand yet, but one seems to be the type of pain associated with it.
"To establish whether the sensory innervation may be important for pain, we characterized the presence of nerve fibers containing calcitonin gene-related peptide (CGRP), a neuropeptide known to be involved in pain processing and persistence of pain through neurogenic inflammation [McMahon, 1996; Mense, 2001]."They measured this in various muscles; findings within various muscles is highlighted below.
"A majority of Fast Blue-labeled DRG cells projecting from the nonspecialized connective tissues of the low back also expressed CGRP, a neuropeptide known to be involved in neurogenic inflammation [Hughes and Brain, 1991; McMahon, 1996; Mense, 2001]. Interestingly, in the knee joint, 76.7% of Fast Blue-labeled cells projecting from the connective tissues also expressed CGRP [Fernihough et al., 2005], a value comparable to the range of 60–88% found in this study. In the skin, an average of 34.9% neurons counted expressed CGRP [Tsukagoshi et al., 2006]. In muscle, 21.6% (longissimus muscle) and 32.6% (trapezius muscle) of retrogradely labeled cells demonstrated CGRP expression (with a total number of Fast Blue-labeled cells similar to that observed in our study) [Tsukagoshi et al., 2006]. In addition, a study of the gastrocnemius-soleus muscle revealed that a greater number of fibers expressing CGRP were within the connective tissues associated with the muscle as compared to the muscle itself [Reinert et al., 1998]."[TW: jello reference]
To illustrate, here's a picture of a strand of muscle fiber; all the white stuff is essentially connective tissue... I've started to think of it as a bowl of jello for things to sit in and when the jello consistency is off, things go awry. Oh, and that jello has feelings.
The overall findings were that, essentially, connective tissue may be a large part of chronic low back pain:
"Taken together the results of the current study suggest that the sensory nerve fibers observed in the nonspecialized connective tissues of the low back may contribute to pain perception."So... what if we sense pain and irritation in connective tissue in ways that aren't "typical"? Again, this is not to say we're "imagining" pain but rather helping to explain how pain expresses itself, and then how we may sense that expression differently than neurotypical brains given the high rates of comorbidity between chronic pain. trauma, and autism.
Okay, I need to stop because I'll end up launching myself into even more rabbit holes right now.
Until next time...
Stay regulated,
Shauna
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