Brain Damage from Chronic Pain

The Damaging Effects of Chronic Pain on the Brain – Wellescent.com – originally posted 2015

Wellescent.com is a defunct website (2008-2014), but still holds a lot of interesting and useful information.

How Does Chronic Pain Change Behavior?

Now, it is one thing to talk about changes in the brain, but what most of us will find important is how brain changes affect behavior and personality. Previous research has found a number of changes in mental function caused by chronic pain. 

One example is that those suffering from chronic pain have difficulty making even simple decisions and interacting with other people.

This has become a serious and embarrassing problem for me.  

I’m becoming less and less able to make decisions, even trivial ones like what to wear or whether to one thing or another. I have trouble answering simple questions involving a decision, like when to do something or choosing from a few options suggested. And I get hopelessly lost trying to schedule a few activities in the correct order, flailing around in the underbrush of pros and cons and priorities and limitations and further possibilities. 

I just can’t maintain my concentration very long.

This finding makes sense because of the over activity of those specific areas of the brain involved in processing pain.

Essentially, because of the constant internal brain stimulation, a person in chronic pain is impaired.

The impairment is similar to what is experience by those who are trying to multitask. Too many things happening in the brain at once makes concentration difficult.

Chronic Pain And Anxiety

In addition to these symptoms, yet another symptom frequently experienced by those in chronic pain is anxiety.

Based on research from the University of California, researchers observed that patients in chronic pain have reduced brain activity in the areas of the brain that control the human response to pain.

I notice this in myself. Instead of getting habituated to the repeated pain and learning to ignore it, I feel like I’m becoming allergic and more sensitive to it.

Perhaps this is due to reduced activity of pain control in my brain as described above. After years of constant cerebral work to squelch pain, maybe my poor brain just wore out.

Repeated pain episodes in the same spot (left sacroiliac joint, for example), trigger my concern that the pain will spiral out of control as it has so many times over the past 3 decades. It’s human intelligence that enables us to see patterns and use them to make predictions about what will follow.

In my case, this pattern of pain usually starts with just a little pinching that’s easy to ignore. But over a couple of hours, instead of bothering me less and less, it bothers me more, and more even when I’m busy and not thinking about it.

It just keeps worsening until I or others around me notice that I’m constantly squirming to find less painful positions. (My boss once said it looked just like what his kids did when they urgently had to use a bathroom: the “pee-pee dance.”)

The researchers believe that the reduced control over pain signals causes the brain in these individuals to become extremely vigilant in anticipating future pain. If this is true, it helps explain the heightened levels of anxiety frequently experienced by suffering from chronic pain.

Chronic Pain And Depression

The final symptom that has a significant effect on those suffering from enduring pain is depression.

In the same study at the University of California, the research results led the investigators to believe that reduced pain control in the brain and the complex brain wiring changes causes increased emotional reaction to future experiences of pain and discomfort.

They suggest that this explains why those with chronic pain are often resistant to treatment. Essentially, the changes in their brain contribute to a sense of hopelessness in being able to overcome the pain.

Undoing The Brain Changes When Chronic Pain Ends

Researchers at McGill University found that chronic pain patients who were eventually treated for their pain were able to recover.

  • They found that the brains of these individuals began to increase in mass to levels that were normal.
  • The area of the brain responsible for controlling pain also repaired itself and began to operate normally.
  • Lastly, the number of gray matter cells also increased.

Most importantly, mental abilities returned to normal levels with these patients being able to again perform tasks requiring mental focus.

I’ve noticed I have much better mental clarity when I’m not in pain. Even when focusing on some task, “distracted” from pain and deliberately ignoring it, I become progressively more befuddled as my pain worsens.

Conclusions

Although we are largely familiar with the reductions in quality of life that accompany chronic pain, our understanding of the effects of pain on the brain has not been good.

Chronic pain is debilitating both physically and mentally, causing damage to our brains and mental abilities.

Many of the changes to the brain can subsequently make coping with the pain even more difficult. As a result, physicians need to make greater efforts in treating the chronic pain that patients experience. We now know that failing to do so becomes a failure to live up to the intent of the Hippocratic oath in “doing no harm”.

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