Chronic pain is defined as pain that lasts for more than three to six months and is often associated with a wide range of medical conditions, such as arthritis, cancer, or nerve damage. The neurobiology of chronic pain is complex and involves both peripheral and central nervous system changes.
A Bit of Neuroscience
Nerve Fibers
At the peripheral level, chronic or persistent pain can result from damage to nerve fibers or tissues that cause the release of inflammatory mediators, such as cytokines and chemokines. Then, these mediators can activate sensory neurons, which send signals to the spinal cord.
Spine
Next, in the spinal cord, persistent pain can lead to a phenomenon known as central sensitization. This is characterized by an increase in the excitability of spinal neurons and changes in synaptic plasticity, which can result in the amplification of pain signals and the development of a condition called allodynia (pain caused by a stimulus that is not normally painful) and hyperalgesia (an increased sensitivity to pain). Essentially, your brain is becoming more and more sensitive to pain and triggering the perception of pain when it doesn’t need to.
Brain
At the cortical level, pain that is chronic can result in changes in brain function and structure. For example, persistent pain can lead to alterations in gray matter density, functional connectivity, and neural activity in areas such as the prefrontal cortex, anterior cingulate cortex, and insula. These changes can result in the emotional and cognitive components of pain, such as the experience of suffering and the impact of pain on mood, attention, and memory.
Pain is Multifaceted
Overall, the neurobiology of chronic and persistent pain is a complex and multifaceted process that involves alterations at multiple levels of the nervous system. Understanding these mechanisms is crucial for developing effective treatments for chronic pain syndrome.
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Acute Pain vs. Chronic Pain
Pain that is acute and pain that persists long-term are two different types of pain that are characterized by their duration and underlying causes.
Acute pain is a type of pain that typically lasts for a short period of time, ranging from a few seconds to a few weeks. Acute pain is usually caused by tissue damage or injury, such as a cut, burn, or broken bone. Acute pain is usually sharp and intense and is often accompanied by other symptoms such as swelling, redness, and inflammation. Acute pain serves a protective function, warning us of potential tissue damage and encouraging us to take appropriate actions to protect the affected area.
Acute Pain is A Warning Signal
Pain that is chronic, on the other hand, is a type of pain that lasts for a longer period of time, usually more than 3-6 months. Persistent pain is often caused by underlying medical conditions, such as arthritis, fibromyalgia, or nerve damage. Unlike acute (short-term) pain, chronic (lasting/long-term) pain does not serve a protective function and can be debilitating and frustrating for those who suffer from it. Chronic or persistent maladaptive pain can be characterized by a dull, aching pain that can be constant or intermittent.
The treatment of acute pain usually involves addressing the underlying cause of the pain and providing relief through medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, or local anesthetics.
Brain with Acute Pain
Brain with Chronic Pain
Heal your brain to heal your pain
Key to healing persistent pain is rewiring your brain and increasing the window of tolerance for stress.
