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How Chronic Pain Can Affect the Brain

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chronic pain

We’ve all experienced physical pain of some sort. Whether you’ve had a broken arm, experienced toothaches or seven suffered a papercut, you’ve experienced pain. Now, imagine you suffer with that pain every day. People who are in chronic pain experience this.

Chronic pain associated with such conditions as arthritis, back pain or recurring migraines, can have a profound effect on a person’s day-to-day life when left untreated. Constant pain raises the focus threshold for basic functioning, which leaves the pained person with a greatly reduced ability to find solutions or workarounds to even relatively mundane problems. Something like a traffic jam, which would mildly annoy most people, could seriously throw off the rhythm of someone who is putting forth effort just to get through the day.

Eventually, many people with chronic pain develop depression-like symptoms: lack of interpersonal interaction, difficulty concentrating on simple tasks, and the desire to simplify their life as much as possible, which often manifests as seeking isolation and quiet. Sleeping often makes the pain less intrusive, and that combined with the exhaustion that pain induces means that it isn’t uncommon for a person to start sleeping 10 or more hours a day.

Studies have also shown that chronic pain can actually affect a person’s brain chemistry and even change the wiring of the nervous system. Cells in the spinal cord and brain of a person with chronic pain, especially in the section of the brain that processes emotion, deteriorate more quickly than normal, exacerbating many of the depression-like symptoms. It becomes physically more difficult for people with chronic pain to process multiple things at once and react to ongoing changes in their environment, limiting their ability to focus even more.

Chronic pain, specifically low back pain, can also decrease the gray matter in an area in the brain known as the bilateral dorsolateral prefrontal cortex (DLPFC). This area, located in the front of the brain, is responsible for what are known as executive functions, like the ability to remember past events and the ability to assess and adjust your actions based on the their outcomes.

In a 2011 Journal of Neuroscience study, they found that although the decreased DLPFC did not hinder people’s ability to complete tasks, it did change the way their brain reacted when faced with a challenge. Essentially, those with chronic pain had to use more of their brains to complete the exact same task. In other words, pain makes it more difficult for the brain to process information and problems.

However, these brain changes are not irreversible. A 2009 Journal of Neuroscience study found that “gray matter abnormalities found in chronic pain do not reflect brain damage, but rather are a reversible consequence…which normalizes when the pain is adequately treated.”

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