Chronic “Pain Brain”
Any pain present for longer than three months is defined as chronic pain. Chronic pain disrupts normal cognitive, emotional and behavioral function.
Chronic pain affects 25-30 percent of American children and adults. It costs the United States an estimated $160 billion annually in medical and pharmaceutical costs, disability income payments and lost productivity. Studies have shown that chronic pain patients may share many common features, including cognitive dysfunction, mood swings, anxiety, insomnia and mood disorders.
To better understand the problems presented by a chronic pain patient, it is necessary to construct a working model of brain function. The brain is constructed to function efficiently given a finite amount of available energy. In the normal state, available energy is used efficiently to allow one to navigate successfully in a constantly changing world. To accomplish this, the brain possesses a sensory component that allows it to constantly sample and interpret the external and internal environment.
The brain also possesses a cognitive component that allows sensory data to merge with working and remote memory to accomplish short and long-term goals and plan behavior in an efficient, value-based manner.
The brain has the ability to quickly change cognitive strategies in order to adapt to an ever-changing environment and solve new challenges. The brain also has the ability to maintain proper motivation while prioritizing best choice immediate and long-term options.
It is able to quickly recognize wrong choice strategies and offer rapid successful alternatives efficiently while blocking out irrelevant distractions.
An important component modulates and stores relevant emotional data while sampling and regulating internal feelings. Since the brain must rapidly respond to and modulate stress, it must possess a component to recognize limitations and restrictions imposed on it by genetic and energy constraints.
Additionally, the brain must maintain proper association of value, or reward, with stored and present behaviors. This allows future behaviors to be efficient and allows the brain to work efficiently to maximize available energy.
The Brain of the Chronic Pain Patient
In contrast, the brain of the chronic pain patient is dysfunctional because it has been overtaken by the sensation of pain.
Such a brain cannot use available energy efficiently. This occurs because the brain is no longer goal-directed, but instead has become stimulus directed.
Attention becomes directed by the sensation of pain, which renders the brain unable to regulate attention and perform goal-directed behavior. Instead, the brain becomes focused upon present sensation and driven by reflexive and impulsive behaviors.
The chronic pain patient is unable to remain on task and accomplish goal-directed behavior. Consciousness becomes focused upon internal sensations, all of which are perceived as uncomfortable.
The future is viewed as negative and is guided by expectations of failure, as every situation is assessed catastrophically. The sensation of pain is viewed as an ever-present threat.
This results in the inability to regulate emotions, which is highly distracting to thought. Consequently, there is increased anxiety and an overall inability to relax, reflect and plan.
Satisfaction that was once attained through the accomplishment of rewarding tasks is most — and motivation and enjoyment is lost as well.
Attempts to escape the sensation of pain are futile, leading to an increased sense of hopelessness, anxiety and insomnia.
Over the last two decades, research has shown that the brain retains the ability to change and adapt well into adult life. The most exciting aspect of this change is that it is stimulus dependent. This means that when the brain is given proper stimulation, it can adapt and regain normal function. Neuroplasticity can be utilized to treat the chronic pain patient— with or without substance abuse disorder.
Treating the Chronic Pain Patient
Treatment for the chronic pain patient exploits neuroplasticity and the brain’s ability to change and normalize relevant dysfunctional brain areas. Improved cognitions occur through active engagement and practice and are the basis of treatment.
Treatment strategies engage the patient in activities that enhance and normalize abnormal brain areas. Multiple treatment strategies are utilized to rehabilitate the chronic pain patient’s brain.
Roughly 116 million of Americans live with chronic pain. If you are ready to consider an alternative to narcotic analgesic therapy, Champion Center Chronic Pain Track is an option for those living with chronic pain and addiction who want to transition to a more holistic pain management strategy. Our addiction treatment for chronic pain medication begins with medically managed detoxification designed to effectively treat withdrawal symptoms and protect clients from breakthrough pain. Traditional chemical dependency treatment is then supplemented by additional targeted groups and techniques designed to create an alternative treatment strategy to replace the use of opiates, including:
- Group therapy
- Holistic therapies
- Recovery curriculum
- Pain and Addiction