An excerpt from The End of Back Pain: Access Your Hidden Core to Heal Your Body.

The evolution of our species has been powered and guided by a survival advantage. Our unique adaptation for survival lies in the development of a brain that can plan, worry, and abstract. Perhaps the most important part of our genome is, however, its capacity to allow for adaptation to our environment.

Most of you are well versed in the principles of evolution and its power to be selective for, or favor, a genetic makeup that confers a survival advantage, but the related concept of epigenetics may be less familiar to you.

Epigenetics refers to that aspect of the heritable genetic makeup that allows for individual cells (and thus, ultimately, individuals) to adapt to stressors. Our genome allows for the formation and replication of the cell, but — perhaps ore importantly — it also codes for a cell membrane that can react to its environmental stressors by turning on specific genes that can produce the necessary adaptive proteins.

Through this feature, call phenotypic plasticity, our cells are blessed with the ability to adapt to a changing environment. It couldn’t be any other way, of course, as no genetic map could anticipate all the requirements of a cell living in an unpredictable environment.

An individual also has the capacity to adapt. Although this adaptation ultimately takes place on a cellular level, the cells are interdependent, as are the various organs that are composed of these cells. The adaptation of an individual thus involves an efficient distribution of adaptation in all the interdependent cells and organs. The distribution of adaptation is referred to as symmorphosis.

A good example of symmorphosis is the reaction of the human body to exercise. The stress of exercise channels energy to individual cells throughout the body. These cells react to the stress; but, in addition, the organism as a whole reacts to the stress, and this results in a codependent and functionally distributed adaptation of the cardiovascular system, the muscular system, the skeletal system, and so on. Aerobic exercise may functionally affect the cardiovascular system predominantly, while weight training distributes the energy more heavily into adaptation if the muscles and skeleton, but both instances involve systemic adaptation.

Exercising stimulates the brain to produce more neurons through a process known as neurogenesis. Just a few years ago, it was widely believed that neurons had no capacity to regenerate. We now know that this is not the case. The brain processes far more plasticity than we had imagined. Scientists comparing rats that ran in their cages to those that were sedentary found a dramatic increase in stem cells (new cells that have the potential to assume many different roles) in the active group — in fact, the active rats had twice as many stem cells in the portion of their brain known as the hippocampus. This is great evidence of exercise’s capacity to cause brain growth.

In addition to neuron growth, exercise causes neurons to sprout dendrites. These are the branches of the neurons that allow for networking and communication among neurons. Exercising releases a variety of factors (or proteins) that stimulate neurons. The most well known such factor is brain-derived neurotrophic factor (BDNF). In addition to bringing about dendritic sprouting, BDNF also causes proteins to be produced that facilitate nerve conduction at the synapses. Finally, exercise results in factors that help with neuron metabolism and blood supply — for example, insulin-like growth factor (IGF-1) and vascular endothelial growth factor (VEGF).

Exercise also results in an increase of serotonin, an important hormone involved in regulating anxiety and mood. That uptick in serotonin means that working the back and the body minimizes the distraction of pain and thus helps the back pain sufferer focus on the task at hand.

Exercising the back with proper form and minimal pain allows for the initiation of a biological bait-and-switch. In a person who uses the back in a controlled and successive manner, the brain learns to substitute an expectation of success for an expectation of pain.

The relation of the back to the brain is synergistic. Exercising the back and body potentiates the brain’s capacity to learn; likewise, the brain’s capacity to learn can potentiate health.

The gist

• The brain and the body have a remarkable relationship. They codeveloped as we evolved, and they remain inextricably intertwined.
• The brain and the spine are each blessed with the capacity to adapt. Working on either the brain or the spine has reciprocal and synergistic effects.
• Building back health reduces pain, but it requires changing both our back and our mind.
• Education is an independent enabler of health.
• The brain can promote health through self-efficacy, responsibility and action, and embodied cognition.

Patrick Roth is chairman, neurosurgery at Hackensack University Medical Center, Hackensack, NJ. He is the author of The End of Back Pain: Access Your Hidden Core to Heal Your Body.