Chronic pain affects 30 to 40 million U.S. adults, costing an estimated $600 billion a year. But researchers have learned more about the physiology of pain in the past ten years than in the previous thousand. Pain is created by the brain in response to what it thinks is a threat. Contrary to previous thought, there isn’t just one pain center in the brain, there are many, according to Pain Explained, a publication of the Neuro Orthopedic Institute (NOI) of South Australia. “These parts include clusters of nodes used for sensation, movement, emotions, and memory, and they all link up to each other electrically and chemically.” In chronic pain, some of these nodes are hijacked or enslaved by the pain experience. While this is a complex process, one primary feature of chronic pain is hypersensitivity in the body’s alarm system of sensory neurons whose function is to send “danger” messages to the brain, particularly in the presence of inflammation.
Injured body tissue has a fairly specific window of time for healing. However, pain can persist even when the injury has had time to heal. This typically happens because the body’s natural alarm system becomes hyper-vigilant and abnormally sensitive, sending exaggerated “danger” signals. The brain’s faulty interpretation of these signals becomes deeply ingrained and persistent. “This can mean just touching the skin, or a slight temperature change, might cause the body’s sensors to send danger messages to the brain.” The brain incorrectly concludes that a threat remains, and that you need all the protection you can get. It produces pain, which is the body/mind’s normal way of motivating you to “get away” or escape from the “danger”. According to the NOI, brain responses such as movements, thoughts, autonomic and endocrine responses are then based on faulty information about the health of the tissues at the end of the nerve cells. “It’s as though an amplifier on a sound system is turned up.”
Thought Viruses Maintain the Chronic Pain Cycle
Thoughts and beliefs are nerve impulses too, and part of the chronic pain loop. As the NOI explains, “the brain has learned to be very good at protecting you from anything that might be dangerous to your tissues. Anxious and worrisome thoughts are threatening to a brain that is already hyper-vigilant about your survival. Research has identified thought processes – “thought viruses” – powerful enough to maintain a pain state. Some powerful thought viruses include:
I’m in pain so there must be something harmful happening to my body,”
“I’m staying home and not going out until all the pain goes away,” and
“I’m so frightened of my pain and of injuring my back again that I’m not doing anything!”
Meditation Helps Chronic Pain Sufferers Diminish “Thought Viruses”
People who practice mindfulness meditation find pain less unpleasant because their brains anticipate the pain less, according to a 2010 study. Scientists from the University of Manchester discovered that regular meditators show unusual activity during anticipation of pain in part of the brain called the prefrontal cortex, a region involved in controlling attention and thought processes when potential threats are perceived. “Meditation trains the brain to be more present-focused and therefore to spend less time anticipating future negative events. This may be why meditation is effective at reducing the recurrence of depression, which makes chronic pain considerably worse,” said the lead researcher. The value of meditation is that it soothes the hypersensitive threat/alarm/danger system at play in chronic pain.
Depressive Thoughts Make Pain Worse
In new study at the University of Oxford, researchers induced a depressed mood in study participants and found this disrupted the neural circuitry that regulates emotion, causing an enhanced experience of pain. Researchers believe that a sad mental state disables our ability to regulate the negative emotion associated with pain. Thus, pain has a greater impact. “Rather than merely being a consequence of having pain, depressed mood may drive pain and cause it to feel worse.” Mindfulness meditation is beneficial in preventing the relapse of depression by strengthening the practitioner’s ability to recognize the physical, cognitive, and emotional effects of depressive thoughts, and to proactively “decenter” from those thoughts.
Communication in the Brain Affects Pain
A 2012 Northwestern University study is the first to show that chronic pain develops the more two sections of the brain – related to emotional and motivational behavior – talk to each other. The more the frontal cortex and nucleus accumbens communicate, the greater the chance a patient will develop chronic pain. “The nucleus accumbens is an important center for teaching the rest of the brain how to evaluate and react . . . . and may use the pain signal to teach the rest of the brain to develop chronic pain,” said the study’s senior author.
With this knowledge of how and why chronic pain develops, and with training in mindfulness meditation, you have tools for influencing patterns of thought and emotion that may be driving your pain. Mindfulness meditation is a complementary practice which can enhance standard medical treatment by your healthcare provider. You can proactively change the vicious cycle of chronic pain.