For those who develop chronic pain, the experience is life changing to say the least. Suffering from unrelenting pain every hour of the day is draining and will often cause drastic reductions in quality of life. Among those afflicted with such sustained suffering, the effects of the pain frequently intrude into many aspects of daily living. That said, for the most part, these effects of chronic pain are something of which most people are aware.
Where general awareness is far less, however, is with respect to the effects of chronic pain on the body. In particular, chronic pain changes the way that the brain works. This means that untreated or under treated chronic pain exposes patients to more than just levels of discomfort. Poorly treated long term pain leads to a form of brain injury in patients. This suggests that physicians have a greater responsibility in taking steps to reduce the pain that their patients experience.
Throughout evolution, pain has served an important role in self-preservation. A feeling of pain tells us when we have been hurt so that we can ideally change the activities in which are we are involved. But, when pain becomes chronic, it no longer serves its primitive role in prompting a fight or flight response. Indeed, in modern society, where most individuals are distanced from threats of physical injury, chronic pain is a significant contributor to unnecessary suffering.
Who Suffers from Chronic Pain?
Within the population, this results in roughly 20 to 25% of people living with chronic pain. In the US, low back pain, the most common form of chronic pain, affects between 24 and 30% of the population.
Because this form of chronic pain is so common, scientists have conducted considerable research on the topic. What the research has revealed over the last two decades is the way in which the presence of chronic pain alters the brain.
How Does The Brain Change In Response To Chronic Pain?
Research from Northwestern University in 2008 determined that the brain activity in patients with chronic pain is different from those who do not suffer ongoing pain. Specifically, the researchers observed that a front area of the brain largely associated with emotion is constantly active in people suffering with chronic pain. This contrasts with the normal activity of the brain where changing activities and thoughts cause different areas of the brain to become active while other areas become less active.
The researchers believe that the result of this excessive activity is that the brain nerve cells or neurons in the specific overactive region of the brain wear out and die prematurely. These nerve cells are described as gray matter and researchers have, in the past, observed lower numbers of these cells in the brains of those suffering from chronic pain. In one study, the research recorded as much as an 11% reduction in the overall size of the brain in those suffering from such ongoing pain. This sort of reduction in brain material typically takes place over 1 or 2 decades in healthy individuals.
In addition to the changes in gray matter, the constant nerve activity and firing of these nerves also causes the nerves involved in communication to rewire in ways that are very different than in a normal brain. These nerve cells are the brain’s white matter or “cabling” and they tend to form more complex wiring patterns for chronic pain sufferers. In particular, they form more links between the parts of the brain that process pain, stress and emotions.
Lastly, the changes in brain activity in chronic pain sufferers also affect the area of the brain responsible for directing sensory stimulation. The cells in this area become less used and atrophy over time causing this area of the brain to shrink.
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