Chronic pain is defined as pain that lasts at least 12 weeks or a long time after the
injury has healed.
Chronic pain represents a malfunction in the brain's pain processing systems. The
pain signals take detours into areas of the brain involved with emotion, attention
and perception of danger and can cause gray matter to atrophy. That may explain
why some chronic pain sufferers lose some cognitive ability.
More than 116 million American adults—one-third of the population—struggle
with chronic pain, and many are inadequately treated, according to a report by the
Institute of Medicine in July, 2011
Yet abuse of pain medication is rampant. Annual deaths due to overdoses of
painkillers quadrupled, to 14,800, between 1998 and 2008, according to the
Centers for Disease Control and Prevention. The painkiller Vicodin is now the
most prescribed drug in the U.S. Opioids are getting approval for usage.
"There is a growing recognition that drugs are only part of the solution and that
people who live with chronic pain have to develop a strategy that calls upon
some inner resources," says Josephine Briggs, director of national Center for
Complementary and Alternative Medicine (NCCAM), which has funded much of
the research into alternative approaches to pain relief.
How we think about pain is how we feel the pain.
Neuroscientists are reaching this conclusion as they use the scanning technologies
to see how the brain processes pain.
That is the principle behind many mind-body approaches to chronic pain that are
proving effective in clinical trials.
Some are as old as meditation, hypnosis and tai chi, while others are far more
high tech. In studies at Stanford University's Neuroscience and Pain Lab, subjects
can watch their own brains react to pain in real-time and learn to control their
response—much like building up a muscle.
When subjects focused on something distracting instead of the pain, they
had more activity in the higher-thinking parts of their brains. When they "re-
evaluated" their pain emotionally—"Yes, my back hurts, but I won't let that stop
me"—they had more activity in the deep brain structures that process emotion.
Either way, they were able to ease their own pain significantly, according to a
study in the journal Anesthesiology in October, 2011.
When we go to Gym and workout, or take part in a marathon, and our muscles
are sore, we interpret it as positive and say we worked hard or we had a good
workout. But, persons with chronic pain like fibromyalgia are getting similar pain
signals, but they experience them very differently, especially if they fear they will
never get better.
"The mind is like an onion. The outer layer, or conscious mind, deals with
intelligence, reality, and logic. The inner mind is concerned with emotion,
imagination, and memory, as well as the autonomic nervous system which
automatically controls our internal organs (i.e., how we breathe, send oxygen to
our blood cells, or walk without using the conscious mind.) The internal mind is
on autopilot, reacting to the dictates of the pleasure principle. It seeks pleasure and
avoids pain" (Warren, 2003, pp. 175-6).
We are all carrying the baggage (I like to call it a black bag), from our past
experience and we use that information to make projections about what we expect
to happen in the future.
According to Gestalt theory, string theory and Pythagoras, we make connections
to past events of pain associated with emotion and link them. We link all the pain
episodes though they are separated by many days, months are years and link them
and draw a conclusion we are always in pain. The dysfunction "feeds on itself,
like a record player just giving you back what you record on it, only many fold,
more every time another pain episode happens. “You get into a vicious cycle of
more pain, more anxiety, more fear, and more depression. We need to interrupt
We need to break that chain. Integrative/holistic modalities help us do just that.
Diagrammatic Representation of how brain processes pain