A new study published by Nature Neuroscience this week suggests that chronic pain is all in your head, although not in the way you might think.
According to the report, brain regions related to emotional and motivational behavior communicate more in people who develop chronic pain, suggesting that the state of mind one is in after an injury determines whether or not chronic pain will develop.
“For the first time, we can explain why people who may have the exact same initial pain either go on to recover or develop chronic pain,” said Prof. Vania Apakarian, from Northwestern University, Chicago.
“The injury by itself is not enough to explain the ongoing pain,” Apkarian added. “It has to do with the injury combined with the state of the brain.”
The authors looked at brain images of 40 people with recent onset of back pain and found they could predict with 85 percent accuracy who would develop chronic pain. The variable was the level of communication between the frontal cortex (cognition) and the nucleus accumbens (emotions and motivation).
Most people suffering from chronic pain are acutely aware of the correlation between pain and emotions, but this study sheds light on the details surrounding the inception of chronic pain. The emotional reaction to an injury is directly proportional to the persistence of pain. Prof. Apkarian explains:
“It may be that these sections of the brain are more excited to begin with in certain individuals, or there may be genetic and environmental influences that predispose these brain regions to interact at an excitable level. Now we hope to develop new therapies for treatment based on this finding.”
The study demonstrated a definite association between levels of communication in the brain and chronic pain; however, it didn’t show causality, leaving the results open to further interpretation. The unique brain activity associated with chronic pain may very well be a result of a unique type of injury, or perhaps a result of a person’s pain tolerance. Despite all of this, the study has proved to be a landmark case.