Pain is a component of life that we must all face at some point. We are first introduced to the idea of pain at a young age. Often we are so young during our first painful encounter that many of us may not be capable of recalling our first memory of a painful stimulus.
Most often instances of pain are acute, meaning that they come on rather quickly due to an immediate injury such as falling off of a bike, or breaking a bone. The pain resolves once the injury resolves.
By the early toddler years, we tend to understand the basics of pain, and we learn very quickly how unpleasant pain can be. It is at that moment that the very early training begins. We begin to train our brains to expect pain only after following an injury. We train our brains to understand that pain is a negative stimulus that should be resolved as quickly as possible. We train our brains to understand that all pain can be resolved with intervention whether it by intervention from a physician, or a band aid in the early years.
When pain becomes chronic, these basic pain principles that we have built our understanding around are shattered. We must now wrap our heads around a completely new concept of pain. Our brains scramble to try and make sense of a situation that we were never told was a possibility.
- The initial injury may have already resolved, but the pain has not gone away.
- The pain may in fact have become worse since the initial injury has healed.
- The initial injury may never heal itself, such as in the case of arthritic changes in the body.
- There may be no known injury to cause the sudden pain.
- The pain may not be a part of your life.
This is much different from the principles of pain that we have come to understand throughout or lives. Our brain must now re-train itself to better understand chronic pain, and to be able to better manage chronic pain.
The problem arises once our brains have been re-trained to expect the pain as a way of life rather than just a part of it. When we experience pain on a daily basis, our brains are now trained to understand that the pain is inevitable. We then begin subconsciously making changes to our daily lives to try and avoid aggravating the already existing pain. This can lead to overcompensation, in activity, isolation and ultimately can lead to living in fear of the pain.
But what if we could once again, train our brains into viewing pain differently? Perhaps, even “unlearn” the thoughts surrounding chronic pain that our condition has instilled in us.
Two new studies out of the Hiroshima University Medical School have found that a percentage of the pain that is still present even after the original injury has healed is a type of learned behavior. They were able to conclude this by examining the imaging and patterns of the brain.
The students examined the resting state functional magnetic resonance (rFMRI) of both those who suffer from chronic pain, and those who do not. They found that there was an abnormally high Intrinsic Connectivity Network (ICN) connectivity within the Dorsal Attention Network for those who suffered with chronic pain. This finding lead researchers to believe that the brain can actually rewire itself in the case of those living with chronic pain when they have continuously focused our attention on their pain and the anticipation of pain.
It is suggested that this “re-wiring” could play a part in the ongoing pain after the physical injury has already resolved. In short, this study has concluded that the pain felt after an injury has resolved is not “in the head” of the patient. It is very real and the changes can be seen within the nervous system of the patients.
Neuroscientists out of Eberhad – Karls University of Tuebingen in Germany believe that this is a case of classical conditioning.
Normally, pain results from an unconditioned stimulus. There is an injury. This injury is usually unpredictable and accidental. Then there is pain. The pain is also unpredictable and unconditioned.
Now when we take a closer look at chronic pain, we see how we can create a conditioned response or a “learned behavior.” With chronic pain there is an injury. There is also pain. The pain is chronic, and so we have memories of that injury and that pain. We collect and recap the memories of our pain, even if we are not experiencing that degree of pain at the present moment. This leads to stress and anxiety, which in turn will lead to an increase in our pain sensation and sensitivity. This would be considered a conditioned response to pain. This can create a vicious cycle that loops over and over again until there is an intervention that can change the thought process.
Cognitive behavioral therapy teaches how to better control the thoughts and anxiety that can be associated with pain. It is a way to train the brain how to unlearn they cycle of negative thoughts which can lead to an increase in pain.
Mindfulness has also been used in the treatment of chronic pain to help patients take back control of their bodies and minds.
All pain is real. And pain has an effect on every aspect of our lives. Chronic pain can change our lives as we know it. Chronic pain can change who we are and take us far away from who we were. But the mind is a powerful tool that can be used to counter the effects of the outside world. With training, we can teach our minds to adapt to anything, even to the pain. We can take back the control over our lives and in turn, get a little closer to the person we once were.
