WORLDVIEW: The fascinating truth about chronic pain

Chronic pain sufferers will know how relentlessly grinding and exhausting it can be to live with daily pain. Often, the pain stems from an old (and healed) injury or a long-cured ailment, creating enormous frustration for the sufferer, who is unable to "fix" what ails them..For many, chronic pain becomes a major drain on their quality of life. Pain medications such as opiates have failed to convincingly demonstrate their ability to deal with chronic pain and indeed may make pain worse when used long term. These drugs can also have troubling side effects, like addiction. Sufferers can be left feeling desperate and powerless..Happily, new imaging techniques and a new approach to understanding the body more holistically are leading to some major advances in the management of chronic pain..___STEADY_PAYWALL___.It's real… and it's all in your head.The modern approach to pain starts with the recognition that all pain – including acute pain from a sudden injury – is just in your head. When you break a bone, you feel the pain at the site of the injury..But in a biochemical and neurological sense, the pain is actually your brain's opinion of how serious and dangerous the injury is. We've all heard stories of people sustaining horrible injuries that they don't feel while rescuing their children from harm, and many of us have had the experience of whipping a hand off a hot stove before we sense the pain of the burn..What's happening in these cases is that the brain decides to "short circuit" our experience of pain in order to deal with a more pressing problem. The pain comes later when it's time to deal with the damage, but it's delayed to allow us to deal with the problem first..Chronic pain is similar, in an opposite kind of way. In the case of chronic pain, we may begin with an injury or a physical illness. But long after the underlying cause has been addressed, the brain continues to give us an experience of pain. There are many factors that can contribute to this, including personality traits, environmental stressors, and a host of other things..Both types of pain – acute and chronic – are real. After all, all that pain is is something we experience, an unpleasant sensation. Whatever its cause – whether it's a snapped bone or a hardwired pain response to an old trauma – pain is pain..However, while all pain is real, treatment options must vary depending on the source of the pain. In the case of a broken bone, you'll feel a lot better when you get some painkillers and medical treatment. However, if your once-broken wrist continues to hurt you a year later, you are in the realm of chronic pain and different treatment rules must apply..Treating pain with no 'cause'.Pain that originates in your neurological system must be treated where it's happening – in your head. This means skipping the pills in favour of treatments that target things like your beliefs about pain, your anxiety, and your habits, as well as things that support your overall health and resilience..Exercise and a healthy diet should be your first port of call. Eating foods that help reduce inflammation and support healthy weight can make a huge difference in the quality of life for chronic pain sufferers, as can exercise. Finding a physical activity that is fun and enjoyable can be even better – research shows that positive experiences can reduce our sensitivity to pain.Cognitive behavioural therapy (CBT) is an approach to therapy that focuses on changing our patterns of behaviour and our beliefs by targeting our thoughts. For those with chronic pain, CBT can be very helpful. CBT for pain management focuses on changing our beliefs about pain. Pain is a negative experience, but we can make it worse by getting anxious and by focusing on it too much or thinking scary thoughts about it. CBT has been shown to improve life for chronic pain sufferers by changing the way they react to pain.Body therapies such as acupuncture and massage can be surprisingly effective remedies for chronic pain. Part of the reason may be a simple placebo effect, but no matter why these therapies work, they do work. And they are a lot less risky and potentially harmful than long-term painkiller usage..For those who suffer from long-term, chronic, perhaps idiopathic chronic pain, new brain-focused approaches to pain management offer hope of long-sought relief. As scientists continue to map how the brain activates and changes in sufferers, we will doubtlessly discover new ways to help improve lives and, perhaps, eliminate chronic pain.

WORLDVIEW: The fascinating truth about chronic pain

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