What Happens to the Brain When You Have Chronic Pain?
As researchers find there is a direct connection between chronic pain and the brain, we can use this information to create better treatment options.
Chronic pain is pain that lasts for longer than three months. It can be caused by injuries to any part of the body. Chronic pain can also be related to headaches, arthritis or for a reason that cannot be diagnosed.
Because we have learned from the Center for Disease Control that over 20 million people suffer from chronic pain, we also know this means nearly 50 million brains are being affected by chronic pain in the brain.
Chronic pain is now being classified as a neurological disease, and researchers are finding it has negative effects on:
- Mood
- Sleep
- Memory
- Other important brain functions
Some researchers feel they have identified two specific parts of the brain that may directly impact chronic pain.
Chronic Pain in the Brain: Thalamus and Prefrontal Cortex
One research team studied the brains of those with chronic pain and compared them to brains in people without chronic pain. Their results are fascinating. They found that in all the participants who had chronic pain, two things happened that did not happen in the brains of people without pain.
First, the thalamus showed major differences.
When you have an injury, the thalamus, which acts like a border, opens. It opens so that signals can be sent from the injury to the brain, allowing it to heal the injury properly. Once the injury is healed, the thalamus closes.
In people with chronic pain, researchers found the thalamus had not closed, even though the injury was healed. This means the brain is amped up and constantly trying to send signals, it is working in overdrive and ends up creating pain.
During the process, there is a major loss in the neurotransmitter GABA.
Second, the prefrontal cortex showed differences.
The prefrontal cortex is the part of the brain that regulates emotions. In people with chronic pain, their study found the prefrontal cortexes were reduced in volume.
This means those with chronic pain had a further reduction in the neurotransmitter GABA, as well as an inability to regulate emotions, especially negative ones. Fear, worry, anxiety, depression are harder to suppress.
The Central Nervous System & Chronic Pain
The central nervous system (CNS) consists of the brain, brain stem, and the spinal cord. It controls most functions of the body. The CNS has the ability to change over time. It reorganizes and adjusts to changes in the brain. Those with chronic pain have been found to have chemical, functional or structural changes in the brain.
These changes cause the brain to misfire or send pain signals when there is little to no pain. Essentially, the central nervous system becomes short-circuited, making a normal ache feel like an extreme injury. It amplifies the feeling of pain. It can be described as centralized pain.
Centralized Pain
Centralized pain is defined as any pain that the central nervous system does not process pain signals the right way. For some reason, the central nervous system has been changed or damaged and now makes the body feel constant pain that can be moderate or severe.
Let’s say you fracture a bone in your leg. Pain signals are moving back and forth to your injury and your brain and spinal cord. Your body is doing its job in healing your fracture. After a few months your fracture is healed according to imaging.
However, you still feel the pain of the injury. This means that somewhere in your brain, brain stem or spinal cord, there was a short circuit. Because of this, the short-circuit changed the way your central nervous system responds to pain.
Even though you are healing just fine, and your pain should be easing up, your brain is signaling that the pain is still intense. And even though there is not real physical reason for you to be feeling pain, you are feeling intense pain.
Rewiring the Brain
Many researchers believe that because it is easy for the brain to be influenced to short-circuit or misfire signals, that it can also be trained to provide relief from pain.
One report claims we train our brains to create chronic pain, similar to classical conditioning. The injury is connected to the memory of the injury. Therefore, our memory of the injury continually sends signals to the brain that the injury still exists. It does this alongside excessive worry and anxiety about the injury.
Simply, the brain learned pain.
But just like something can be learned, it can also be unlearned, according to some researchers. The process is called extinction.
Through cognitive behavioral therapy, re-conditioning can happen that changes how a person recognizes pain. Instead of fearing pain, they learn to recognize it but ignore it because they recognize there is not real need for the pain.
Furthermore, treatments like acupuncture and biofeedback can help chronic pain sufferers.
How to Get Started
Before you start looking for someone to give you a brain rewiring, you must connect with a pain management specialist who can give you a comprehensive evaluation. You want a doctor who can assess you physically, to check for potential causes of pain.
While you may think your injury is healed, it is best to receive imaging and evaluation to double check. Treatment will be very different if there is an actual source of pain. Depending on your pain condition, you may receive injections, stimulation or even ablation procedures.
If your chronic pain is found to be unrelated to an injury, your pain management specialist can offer a wide range of complementary treatments.
Finding the Right Specialist
To find the right pain management specialist, look for someone who provides education on pain so you understand why your body is feeling pain. As a patient, you do not want a doctor who simply tells you what they think is wrong and pushes you into a procedure.
A person wants a doctor who can answer your questions about your pain and how it is related to the brain and the body.
You deserve a life with less pain and the right doctor can help you achieve it.
