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Chronic Pain Explained

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Chronic pain is a frustrating and elusive condition. We typically classify pain as chronic if it lasts for more than three months. Most injuries that happen to your body can heal within three months. When the pain lasts longer than that it is deemed, “chronic pain.”

If we continue to feel bodily pain past a three-month time window; then there is usually a neurological component involved in that pain. In this type of situation the brain is creating the pain message after the body has actually healed. The feeling of pain that person has felt has been overwritten in the brain, and is now using up additional brain space. An extreme example of this would be phantom limb syndrome, when a person loses a limb and still feels sensation where there used to be an arm or leg.

This is an example of what the difference looks like between an acute pain and chronic pain throughout a brain.

When we are injured our brain reacts to the pain. There will be increased activity in parts of our brain that map out: sensation for that area of the body, balance centers associated with the harmed location, emotions that are related to that injury and parts of the brain related to the function of the injured area.

Below is an image with a homunculus representing the various parts of our bodies and where the sensation and motor activity are mapped out in the cortical regions of our brain.

These specific areas are not set in stone, but are fairly uniform with a normal healthy individual. If you were to injure your thumb for instance, the area of cortical brain activity for the thumb will enlarge. If that injury persists, then the brain will continue to use increasing real estate. When this happens over a prolonged period of time the brain continues to react even after the tissue has healed. Not only is the area of the thumb on the homunculus sensitized, but many other areas in the brain will have increased activity as well. As an end result, the pain which has become “chronic” starts to use increased areas of the brain. As a result of this our usual brain function suffers.

Having a brain that keeps on producing pain, even after the body’s tissues have healed, is no fun.

Our patients hear me explain from time to time that I am not so concerned in their pain as I am in how their body is functioning. I do not lack empathy, nor am I cruel, but I do recognize that the brain will often send an inaccurate message of increased and/or lingering pain. Although pain is the language of the body sometimes this language becomes a broken record. Even past the point where our bodies have been damaged our brain continues to perceive increased pain.

We are using some cutting edge therapies in the clinic to address this issue. Call and schedule an appointment with Dr. Grace to learn more. NPSPDX.com 503.684.9698

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