What Does Chronic Pain Do To the Brain?
Chronic pain is defined as pain that lasts longer than 12 weeks.
And it’s complicated - more so than people think.
Most people that experience chronic pain look normal. Often, there are no obvious signs of their pain, such as a deformity or discoloration.
I worked in a clinic where most of the patients who suffered from chronic pain didn’t look like they had chronic pain. The only telling part was when they talked about it. Or when they moved in a way that amplified their pain. And sadly, it frequently impacted almost every aspect of their life.
Chronic pain makes it hard to function at a job or at social events. It makes exercise difficult and travelling can feel impossible. It impacts relationships. It changes the brain. It can lead a person down a slippery slope involving anxiety and depression.
Many health articles brush over the connection between the nervous system, the brain, and chronic pain. But this link is critical in explaining how and why pain becomes chronic.
Yet, chronic pain changes the structure of the brain. The central nervous system can even increase the intensity of the pain. Your body works against you. It short-circuits. It’s frustrating. So, what exactly is going on?
How Chronic Pain Develops
The nervous system, more specifically the spinal cord, receives signals from all over your body. And these signals constantly update. It’s how you learn to ride a bike, amongst many other activities. It also teaches you what signals to ignore. For example, you aren’t constantly aware of that sock falling down or the shirt on your back. Your spinal cord filters out these signals, so you don’t notice them.
In the muscles and other tissue, signals are sent to the central nervous system updating it on endurance, flexibility, and strength. When chronic pain happens, these signals in the muscle and other tissues misfire.
It often starts with a more acute condition or injury. Maybe you strained a muscle in your low back. You might become cautious with movement. And then, when you do move, you experience pain.
In turn, your body and central nervous system become hypersensitive to these signals. While you might normally interpret your back as stiff or slightly achy - and you might normally just ignore them entirely - your spinal cord instead takes these signals and amplifies them. Your brain receives loud and intense pain signals. This concept is called central sensitization. And it means that even harmless stimulation to the area can cause pain.
Yet, it’s not the only reason that chronic pain develops. Chronic pain can occur from underlining and chronic conditions, such as arthritis or repeated trauma causing inflammation. However, central sensitization can play a role in these conditions as well.
The takeaway here is that chronic pain changes the way the central nervous system works. And this includes the brain - which we’ll take a closer look at shortly.
Chronic Pain & Its Impact on Your Brain
Chronic pain affects the brain in a variety of different ways. It can change the way you think. It can change the structure of the brain. And it can have a significant impact on your mental health and your cognitive abilities.
The thing about the brain is that it is a very adaptable piece of the human body. It is constantly changing. Due to this, many of the changes caused by chronic pain are reversible. So, what exactly are these changes?
1. Chronic pain decreases the grey matter in the brain.
In 1 year, chronic pain can decrease grey matter by 11%. The brain is made up of grey and white matter - named so due to the lighter and darker appearance of the tissue. The grey matter contains the cell bodies and axons of neurons. In other words, it’s where neurons communicate with each other in the brain. It’s the part of the brain involved in muscle control, memory, emotions, decision-making, and more. When these areas shrink, your cognitive functioning and mental health can decline.
2. The prefrontal cortex shrinks as well.
Individuals with chronic pain have increased activity in this area of the brain. You think that would be a good thing. But it actually decreases the life of these neurons, which slowly shrinks the prefrontal cortex. With consistent and constant pain, your body is not given enough time to regenerate these areas. It becomes a problem.
Anxiety and fear are common emotions in individuals with chronic pain. Why? Because the prefrontal cortex is responsible for controlling our emotions. These individuals have less control over these emotions because of the loss of neurons in this area of the brain. It results in increased feelings of anxiety - an aspect that commonly goes unaddressed in the healthcare system.
Only recently have chronic pain programs and treatment protocols begun to take into account the psychological impact relating to chronic pain conditions. Many innovative approaches are starting to combine cognitive behavioural therapy with conventional medicine and exercise.
3. Chronic pain decreases the size of the hippocampus.
The hippocampus deals with our emotional responses, memory, and learning. Chronic pain decreases the size of this area. It further explains why individuals with chronic pain experience severe anxiety and also learning or memory difficulties.
4. Chronic pain can lead to depression.
The anxiety. The inability to function. It can lead to depression and other mental health issues. In turn, studies have shown that depression can decrease the white matter in the brain. White matter links different parts of the brain to each other. This, combined with other changes, can cause a severe decline in one’s quality of life.
Early Treatment Can Prevent These Detrimental Effects
As with any condition that causes pain, it’s important to seek out proper care early on. It can prevent the situation from descending into a more chronic condition. And consequently, it can prevent any future ill effects from occurring. Further, staying positive and surrounding yourself with a positive support system can work wonders when it comes to healing and recovery.
Surprisingly, many health articles indicate that cognitive behavioural therapy is essential to overcoming chronic pain. This means incorporating proper coping strategies and techniques. These strategies and techniques may include meditation, positive self-talk, visualization, and more.
Chronic pain is just as much a mental game as it is a physical one. But it doesn’t have to rule your life.
If you suffer from chronic pain, book an appointment with your doctor. Explore your options. Many chronic pain conditions are treatable - even without surgery. Understand your condition and step forward toward a better life. Start today!