What is Chronic Pain?

 

Chronic pain is any pain that has lasted 12 weeks or more. It is a common, complex, and distressing condition, which has an impact on the individual concerned, their family and society.

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Studies estimate that one third of adults in the UK are living with chronic pain, and high impact chronic pain limits daily activities for over 1 in 10 UK adults*. 

(*Chronic pain in adults 2017 - Health Survey for England. Public Health England)

 

Medication has its role, but also has its limitations with side effects and risks of tolerance and dependency, meaning that higher doses might be required which further increases the risk of side effects. Surgery and injections may not fully eliminate chronic pain and also have their own associated risks.  Many patients are left with significant debility despite exhausting all standard medical and surgical treatment options and can lose hope of recovery.

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Now for the hopeful part….

 

Latest neuroscience research has shown that the brain plays a central role in our pain experience and it is here that a holistic treatment approach can be so effective. When we suffer an injury, sensory data from the body is sent to the brain via nervous system pathways, which then processes and analyses the data at a subconscious level and will create the symptom of pain if it suspects there is a risk of tissue damage. This is an automatic process that happens without us even thinking about. Pain is produced for your protection so that you rest the injured part.

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However, pain can be a false alarm as the brain sometimes makes a mistake and signals pain in the absence of actual tissue injury or might continue to produce pain long after any injury has healed.

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Most cases of chronic pain are not actually due to significant structural damage in the body (even though scans might show evidence of damage) but are the result of a complex interaction between brain, mind and body, resulting in what’s known as neuroplastic pain. This is much more likely to occur if you've been going through a stressful time or have had significant stress or trauma in the past as this can sensitise your nervous system. This results in pain being produced by the brain despite there being no significant tissue damage or risk of harm in the majority of chronic pain sufferers.

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This centralised or neuroplastic pain is neither imagined nor a symptom of mental illness. It is real pain and just as severe as pain caused by tissue injury, but it does not mean that there's anything seriously wrong with you. The good news is that once this is accurately diagnosed, it is amenable to treatment with pain reprocessing therapy. However, if it has not been identified as such, neuroplastic pain leads to frustration, worry and distress, alarming the brain further to activate more pain pathways and a vicious cycle of chronic (long-term) pain is established. 

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This series of animations created by Mind-Body Medicine Specialist Dr Schubiner really helps to explain the brain's role in the development of chronic pain: