In many ways, your brain is similar to your computer's central processing unit, or CPU. It’s where all sensory inputs from the body are received, interpreted and stored, and it gives instructions on what to do with this information. There's one major way, however, that your brain is different from a CPU: your brain can physically change based on what it learns.
“Chronic pain is defined as a state of continued suffering, sustained long after the initial inciting injury has healed. In terms of learning and memory one could recast this definition as: Chronic pain is a persistence of the memory of pain and/or the inability to extinguish the memory of pain evoked by an initial inciting injury.”1
Thoughts and emotions directly affect your level of pain
Pain has long been viewed as the simple sum of things like tissue injury and inflammation. Doctors are just beginning to understand how it's more complicated than that—how pain is a sensory and emotional experience. We now appreciate that pain is heavily influenced by previous experiences and expectations. Recent improvements in neuroimaging (such as MRI scans of the brain) have allowed us to see for the first time structural and chemical changes associated with both acute and chronic pain. These scans provide visual evidence that our thoughts and emotions (such as attention, anticipation and particularly fear of pain) can dramatically change how we feel. It's also clear that we can learn how to modify our thinking and by doing so, alleviate a lot of pain.
How neuroplasticity affects chronic pain
Neuroplasticity is the ability of the human nervous system to modify its configuration and function in response to certain stimuli. This concept can help explain the pain-to-thoughts/emotions connection. You're probably already familiar with the brain’s amazing ability to reorganize itself by learning from its environment: think of visually impaired people who develop a heightened sense of hearing or increased sense of touch. This is the same thing.
Making chronic pain feel more intense
Remarkably, studies have shown that certain areas of the brain known as the pain matrix are triggered in response to pain. The pain matrix is believed to include parts of the cortex (outer portion) of the brain, as well as other areas such as the amygdala, which deals with processing emotions. These other areas help us determine how “serious” or how “dangerous” a stimulus may be. When bombarded with pain signals over time, these areas of the brain actually change (grow or shrink), and so do levels of the neurochemicals controlling your mood.
Neuroplasticity may be the nervous system's attempt to adapt to injury in a positive way. But in the case of chronic pain, neuroplasticity can go awry and make the chronic pain worse. While it is not yet entirely clear why, when or to whom these nervous system changes occur, the brain interprets what used to be minor pain signals as much more intense. As a result, chronic pain can feel much, much worse.
What's happening now
There are reasons for hope and things you can try to help alleviate chronic pain.
- First, neuroplasticity is by nature malleable, meaning that although changes to the nervous system can occur, they are not irreversible.
- In addition, the latest research gives us a better idea of the role psychological factors play in pain and the enormous potential for improvement.
There is no room for the idea that pain is "psychological." That’s obsolete. The truth is that it's all real. We just need more widespread understanding of how psychological features impact neuroplasticity and therefore affect the pain experience.
This is how shifting the views on pain and our reactions to it can help effectively manage pain and even reverse the counterproductive neurobiological changes. Things like staying active, engaged, positive, motivated, purposeful and focused on what you can do as opposed to what you can’t do will all help deal with chronic pain.
- Chronic pain: The role of learning and brain plasticity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4922795/