It’s estimated one out of every four adults in the United States suffers from chronic pain. Defined as pain that lasts over three months. It can be constant or intermittent and affect any body part. The common factor- it interferes with all aspects of life.
Finding safe and effective ways to deal with chronic pain is an ongoing challenge, especially when we now know it can be due to any type of injury in the past or disease processes like arthritis, cancer, and diabetes. It can even occur for no apparent reason.
We now know pain isn’t just a message from injured tissues in need of help, but rather a complex experience that can be fine-tuned and even produced by the brain in response to past traumas. The results can be unpredictable and multifactorial, leading to enormous difficulties in delineating the best treatment options for every patient.
There’s no question the brain makes pain, like everything else we perceive. Whether it’s hot or cold, rough or smooth, awareness of where we are in space, how to walk, sit stand, and breath. The brain defines our world.
It may start with a threat signal, but that’s only one factor the brain acknowledges before creating the sensation of pain. And sometimes, it becomes overprotective and can exacerbate or even be the cause of our pain by sounding alarms so persistently false that it eventually turns into the actual problem long after the initial event is resolved.
We are constantly receiving data from the environment and our tissues, which is then sent up a chain of wiring- similar to that in a building. The brain collates all the inputs to determine if there’s a threat e.g. skin is warming up, get out of the sun. But it also adds past experiences and beliefs to generate a response.
“Last time I touched a hot stove it burned.”
Within 100 milliseconds, the brain evaluates the input and decides what to do. In this case, triggering muscles to move away from the heat.
Initially the brain produces pain by activating regions that have different roles in interpreting and generating further warnings. Like the thalamus which receives input from the spinal cord and then shares this with other networks in the amygdala, insular and cingulate cortex. That then attaches more detailed physical and emotional components, allowing the brain to process simultaneously many sensations.
If danger is perceived, the brain demands more information, so more and more nerves fire in order to allow a wider coverage of the environment, creating a hypersensitive state where all neurons are on alert. This is essential for survival but if the constant firing doesn’t stop, if the brain doesn’t receive the all-clear sign, it can lead to persistent pain long after the threat has healed or resolved.
Leading to the pictures we see on functional MRIs of the normal brain versus one impacted by chronic pain.
Only when the brain says it’s safe, will the body listen.
Now it makes sense why “everywhere” hurts or some can’t pinpoint its origin.
The brain is an amazing organ, capable of learning and adapting as we age. This is called neuroplasticity. But not all it learns may be real. As they say, “garbage in, garbage out.
Even if the input is faulty, the brain still analyzes it as though it were accurate. That’s why how we judge the information is so important. Judgement is left to our minds, not the brains reflexive responses meant to keep us alive and safe when it misinterprets safe signals as dangerous.
Does that mean it’s all in our heads? That we can just think the pain away? Yes and no. No, because the pain is caused by actual signals coming from the brain, not our minds. We are not crazy. And it’s extremely difficult for our minds to boss it around. But there are many ways we can “hack the system” and help the brain stop, rewire, disrupt or distract it from pain indicators. Such as:
- Meditation.
- Mindfulness.
- Graded response therapy.
- Guided imagery.
- Exercise.
- Hot/ cold packs.
- Sleep, sleep, sleep.
- Hydration.
- Visualization.
- Changing negatives to positives.
- Crossing arms.
- Stimulate endorphins and endocannibinoids.
- Light and sound therapy.
- Journal.
- Just breathe.
- Distractions
- Socializing.
- Laughing.
- Scents.
- Artwork.
- Grounding techniques.
The list is incredible! What we do know is the sensation of pain in those suffering from chronic issues is no longer a reliable sign of what’s going on. So, we need to stop thinking of it as an automatic warning damage is eminent or occurring. Most of us are sure we know why the pain changed, improved, or worsened.
“I shouldn’t have gone to work today.”
“I shouldn’t have done the laundry.”
“I shouldn’t have exercised.”
“I should have exercised”
“Driving to the store made me worse.”
“I walked my dog.”
“Lying in bed all day helps”
We are always trying to link up a cause and effect when in all likelihood, none exists. Or using the resultant, normal aches and pains that come from exerting ourselves to be the reason we can’t possibly continue.
We need to understand the pain we feel, in and of itself is no longer a reliable indicator of harm. It always has a layer of brain generated complexity that can worsen the situation or evolve into the outright problem itself.
We have far more control than we think.
Realizing that after a broken hip walking was limited and painful, but now that it’s healed those signals telling us to stop are just remnants of the danger we felt and reasonable boundaries honored while it was healing. Required then, not now.
Pain is created in the brain. Over time, pathways are generated that severely restrict our lives. By learning how it does this we can actually create new ones that decrease the severity and resulting limitations. Using techniques to retrain, re-educate and help the brain to recognize inaccurate data and promote the passage of accurate ones is integral to moving forward and living a better life. Understanding when it’s sending false alarms allows us to tamp the pain down by ignoring the garbage coming in.
I’m asked every day for guidance and help. This works.
We are constantly bombarded with information. It’s up to us to decide which are true and which are false. Knowing, and accepting the difference can be the deciding factor in how much control pain exerts in our lives. And empower us to take that control back.
-https://www.nih.gov/news-events/nih-research-matters/scientists-find-new-pain-suppression-center-brain
-https://www.carenewengland.org/blog/how-pain-works-the-brain-is-the-ceo
-https://www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/pain-brain-connection
-https://www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/pain-brain-connection
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