Pain Matrix

Pain is complicated. It is not black and white, and it is experienced differently by every horse.
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According to the National Institute of Neurological Disorders and Stroke:
“There is still much to learn about how and why people feel pain in different ways. Acute pain with an obvious cause (an infection or broken bone, for example) is much better understood than chronic pain. Research shows that factors and changes in the body (biological), the mind (psychological), and a person’s experiences with others along with the conditions in their environment (social) are all contributors to an individual’s experience of pain. For this reason, pain is known as a biopsychosocial experience.
Biological factors associated with pain include things like brain function and genetics. Psychological factors are things like mood and stress. Social factors include things like having (or not having) a support system or experiencing biased care. Each set of factors affects and impacts one another. Therefore, treatment for pain is both complex and individual.”
Pain is complicated.

Let’s break down pain into four categories or boxes and collectively call them the Pain Matrix.

1. Structural Compromise- this occurs when a joint or soft tissue (tendon, ligament, disc, muscle, etc.) has a structural anomaly or damage that is confirmed via imaging such as  x-rays or MRI (for example: arthritis, bone spur, OCD lesions, tears, overlapping or close vertebrae, etc.)**It is imperative to recognize this is NOT always the cause of the pain. More on that below. **
2. Inflammatory Response – inflammation is the body’s natural response to protect itself. This can include swelling, heat, redness, etc.
3. Muscle and Fascial Tension- muscle and fascial tension occur when movement is restricted. In a pain scenario, the body will naturally guard the injured area and create a compensation pattern that includes overusing adjacent areas of the body where the injury is not present.
4. Nervous System Dysregulation-  nerve signals are sent from the brain to injured areas to tell the body “It hurts!”. This is essentially an alarm system. Sometimes the brain can struggle to return to a normal state and operation of the alarm system after injury. There are many reasons this can happen, and sometimes it happens with no apparent explanation. 
Together, these create a holistic view of pain. To truly support holistic healing, all four categories must be considered and addressed. Let me explain…
 
Have you ever met someone who had back pain with a bulging disc and narrowing vertebral spaces (structural compromise) who was in so much pain they could hardly walk? I am sure you have. But I bet you have also met someone who had the same structural compromise of a bulging disc and narrowing vertebral spaces who was an avid athlete with no pain. How can that possibly be? Because structural compromise is not always the source of pain. You read that correctly. The imaging diagnosis is not always the source of pain. What are the differences between the two people? They are individuals with unique nervous systems. There are many examples which demonstrate that pain is more complicated than expected. For example, people can experience phantom limb pain after amputation, and research shows spine imaging such as X-rays do not correlate with how much pain a person has. The same goes for your horse… Now let’s consider the other three categories in the Pain Matix.

A healthy inflammatory response will vary based on how healthy the body is prior to the compromise (this goes for structural or immune response). Supporting a healthy inflammatory response includes a clean diet, healthy gut microbiome, stress reduction, and physical fitness. Making sure all those aspects are healthy will greatly assist how your body responds to injury. It’s also important to recognize and appreciate that the inflammatory response is natural. If we completely take it away, we could be disrupting the natural inherent healing of the body. A better approach is to support it, not completely block it.  Supporting it would look like homeopathics, herbs, PEMF, red light, and temporary use of NSAIDS.

Muscle and Fascial Tension: I am sure you can relate; you sprain your ankle or jam your toe and start walking with a limp. Before long, you are leaning and walking with a limp. Then, your back starts to hurt…what happened? You created muscle and fascia tension because you were guarding the injured area. You can also cause compression in nerves. The exact same thing happens to your horse. Muscle and Fascial Tension can create fibrosis and completely change how your horse’s body can transfer motion throughout the body correctly. Regular bodywork that addresses myofascial release and massage is imperative to support healing.
Last but not least, the horse’s nervous system becomes dysregulated when the horse’s alarm system is extra-sensitive. It can be set off by normal daily tasks, resulting in ongoing pain and reduced function. And the more the alarm is set off, the easier it is to set off; essentially, your body gets good at feeling pain. To assist your horse’s body in resetting the nervous system, craniosacral can be very helpful. By supporting the horse’s inherent healing, the nervous system is able to regulate itself and operate in a balanced state once again.   
 
To fully support pain from a holistic and wholistic perspective, pain MUST be viewed considering the entire Pain Matrix. If your horse tears a suspensory ligament or even has a hoof abscess, don’t forget to support the WHOLE body. The LISTEN Approach is a fantastic modality to support pain in your horse. Interested in learning more? Check out the Workshops tab.
 
A Wellness Team is essential for helping your horse deal with pain. Building a team including a veterinarian, farrier, trainer, and bodyworker who can collaborate for the good of the horse is essential.  

Blessings,
Amy