Chronic Pain, its all in your head… sort of!

Part of treating chronic pain involves tricking the brain

It is estimated that 50 million (or about 20% of) adults in the U.S. suffer from some type of chronic pain. 

Some people may think the pain is all in their head, and they are right….sort of.

Our brains process and register our pain. For example, if you touch a hot stove your sensory receptors send a signal up your spinal cord and eventually to the brain, which processes the information and tells you, “Hey, that hurts.”

The more the brain processes pain, the more perceptive it gets. It causes the brain to be hypersensitive to pain. In those with chronic pain, their brains are on “high alert”. Think of a house with an alarm system. The alarm system is your brain. If a baseball is thrown through the window, the alarm system goes off, alerting you to the broken window. In someone with chronic pain, their alert system is overly sensitive. Now, instead of the alarm only going off when the window is broken, maybe a breeze causes a tree branch to skim across the window, setting off the “false” alarm. The alarm system, or brain, is telling you a stimulus is painful when really it shouldn’t be registered as painful.

Chronic pain can significantly impact people’s day-to-day activities and can lead to decreased productivity at work, or maybe even inability to work.  This can lead to people trying anything to get some relief, including taking lots of medications. The good news is, there are other things you can do for pain relief, including physical therapy.

As physical therapists, we have many “tools in our toolbox,” as we like to say, to help you with your pain.

There is also promising research that involves getting your brain to “relearn” or “unlearn” your pain. A study of 151 people with chronic low back completed pain reprocessing therapy and had some pretty amazing results. After 4 weeks of treatment, 66% of the participants were pain-free or nearly pain-free and most maintained the relief for a year. Following the pain reprocessing therapy, the regions of the brain associated with pain were changed when studied on neuroimaging- how cool is that?! 

References:

Ashar YK, Gordon A, Schubiner H, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial [published online ahead of print, 2021 Sep 29]. JAMA Psychiatry. 2021;e212669. doi:10.1001/jamapsychiatry.2021.2669

Dahlhamer J, Lucas J, Zelaya, C, et al. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:1001–1006. DOI: http://dx.doi.org/10.15585/mmwr.mm6736a2

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