Chronic Pain Harms the Brain

[UglyGreed]

People with unrelenting pain don't only suffer from the non-stop sensation of throbbing pain. They also have trouble sleeping, are often depressed, anxious and even have difficulty making simple decisions.


In a new study, investigators at Northwestern University's Feinberg School of Medicine have identified a clue that may explain how suffering long-term pain could trigger these other pain-related symptoms.

Researchers found that in a healthy brain all the regions exist in a state of equilibrium. When one region is active, the others quiet down. But in people with chronic pain, a front region of the cortex mostly associated with emotion "never shuts up," said Dante Chialvo, lead author and associate research professor of physiology at the Feinberg School. "The areas that are affected fail to deactivate when they should."

They are stuck on full throttle, wearing out neurons and altering their connections to each other.

This is the first demonstration of brain disturbances in chronic pain patients not directly related to the sensation of pain.


http://www.sciencedaily.com/releases/2008/02/080205171755.htm




“With chronic pain, your whole life changes in a way that doesn’t happen with acute pain,” said Robert Malenka, MD, PhD, the Nancy Friend Pritzker Professor in Psychiatry and Behavioral Sciences and the study’s senior author. “Yet this absence of motivation caused by chronic pain, which can continue even when the pain is transiently relieved, has been largely ignored by medical science.”




A series of experiments in mice by Malenka and his colleagues, described in a study published Aug. 1 in Science, showed that persistent pain causes changes in a set of nerve cells in a deep-brain structure known to be important in reward-seeking behavior: the pursuit of goals likely to yield pleasurable results. Malenka’s lab has been studying this brain structure, the nucleus accumbens, for two decades.

“We showed that those brain changes don’t go away when you transiently relieve the mice’s pain,” Malenka said. The experiments also indicated that the mice’s diminished motivation to perform reward-generating tasks didn’t stem from their pain’s rendering them incapable of experiencing pleasure or from any accompanying physical impairment, he said.

https://med.stanford.edu/news/all-news/2014/07/study-reveals-brain-mechanism-behind-chronic-pains-sapping-of-mo.html

[lonestarnot]

1. Interesting.

[Tace]

2. I Would Describe It As Such...

I suffered from chronic cluster headaches for many years. I described the longer-term effect this way: When the pain stopped, I was so glad to be in a state of non-pain that I didn't feel like doing anything except enjoy the state of non-pain, which is very pleasurable after excruciating pain. --Tace

[LanternWaste]

3. I'm a Cluster sufferer too.

I'm a Cluster sufferer too. Nasty little thing, this demon of ours.

[Tace]

9. LanternWaste

I'm so sorry to hear of anyone suffering from clusters. It's awful.

I haven't had a cluster attack in 10 years, after having chronic clusters from age 15-35. I finally found that amitriptyline was effective in finally stopping them, but brought an entire set of other very debilitating side-effects. (I stopped taking amitriptyline shortly after my last attack subsided.

However, my daughter began to get clusters early in high school, as I had, and doctors prescribed a low dose of verapamil and it worked to stop the progression of the headaches.

If I knew then what I know now, I would have tried verapamil at the start.

Best of luck. --Tace

[UglyGreed]

13. I wish

you and your daughter the best, must be very hard to watch your daughter suffer with the knowledge of exactly how she is suffering.

[UglyGreed]

10. I have Hydrocephalus

Which came later in life at the age of 46. I suffered for over a year with constant headaches and pressure. I received some relief for about six months after shunt surgery. Then headaches came back and become very bad with very little activity to the point of vomiting and passing out. After dealing with spinal issues for over 20 years I thought it could not get any worse but it has.

[NV Whino]

4. I have a friend in chronic pain

This information explains his situation exactly. I try very hard to be tolerant, but he's a trial.

[cali]

5. I live with chronic- sometime acute- pain

It took me a while, but I've managed to figure out how to cope with it. Exercise, meditation, diet, opiates when needed, and distracting myself from the pain. Nights are the worst. You can't distract yourself when you're trying to sleep.

[NV Whino]

7. Yeah, he doesn't do much to help the situation

Except drink and pop pills. And be grumpy.

[Tace]

15. cali, ouch

I'll be thinking of you in my breathing. : )

[UglyGreed]

12. sure it's tough

to be his friend but please try to give him as much support as you can. Try to imagine how hard it is on him.

[NV Whino]

14. Try to imagine how tough it is on me when he starts damaging my car

because he's pissed at me.

I give him a LOT of latitude, but he's crossed a line.

[UglyGreed]

18. Does

he become more violent after drinking?

[NV Whino]

20. No

I can't say he's a happy drunk, but he's not a violent one.

[UglyGreed]

21. I only asked since

you stated in another post that all he does is pop pills and drinks. Maybe his family or friends need perform an intervention. Sounds like he may be reaching the end of his rope.

[Dont call me Shirley]

6. As with Lupus, Fibromyalgia, Rhematoid Arthritis there is always present a level of chronic soreness

a low-grade dull ache. That never goes away, sometimes it's less sometimes it's more. Always the brain is busy working to ignore the pain so the sore body can continue to function. The person is using much of their energy trying to overcome their pain, setting up a real sense of chronic fatigue. Then even the littlest activity becomes a huge effort. Leaving not much energy for motivation to do things.

[NightWatcher]

11. Now I've got anxiety and the Dr told me it was from the chronic pain

What a kick in the ass. Just when you get used to dealing with the pain, you get something new to deal with.

I've lupus, dermatomyositis, and now apparently anxiety.

[Dont call me Shirley]

17. I'm so sorry! I know what you are going through.

Western medicine does not heal any of these diseases. It only somewhat relieves the multitude of symptoms and the harsh drugs cause more problems than relief.

For real relief and a good degree of healing wholistic medicine is the key. Whole herbs, lots of organic greens fresh vegetables and fruits, limit grains dairy and meat, keep exercising and moving, get good rest, meditation, effective therapy for overcoming emotional/mental negativities, be kind and caring to your own self.

There are a multitude of people on this forum who have an absolute hatred for wholistic medicine and are vocally very outspoken about their hatred, so seek information from other places.

Healing energies I send your way. Love and Peace heals all.

[UglyGreed]

8. Here is another article

As unpleasant as it may be, the evidence is in: chronic pain may produce a loss or atrophy of brain tissue.1-8 All practicing physicians and their surrogates and allies must immediately begin understanding the ramifications of this finding. All parties must be educated about this fact and aggressively attempt to prevent brain atrophy in chronic pain patients. While our knowledge about this dire complication—and what tools we should employ to prevent and treat it—are admittedly meager, we have to begin a new chapter in practical pain management.

The Evidence

In 2004, Apkarian and colleagues at Northwestern University published their initial findings on patients with chronic back pain.1 By use of brain scans they determined that chronic pain caused brain shrinkage by as much as 11%—equivalent to the amount of gray matter that is lost in 10-20 years of normal aging. The decrease in volume in the prefrontal cortex and the thalamus of the brain was related to the duration of time spent in pain. Every year of pain appeared to decrease gray matter by 1.3 cubic centimeters. The good news about this study is that the shrinkage was accompanied by only minimal neuronal loss suggesting that proper treatment might reverse this portion of the decreased brain matter.

Since this seminal report, a number of investigators—from a variety of institutions, using a variety of techniques—have documented loss of brain tissue in chronic pain patients, including those with chronic headaches, fibromyalgia, back pain, and irritable bowel syndrome.2-6 Most of the major studies involving chronic pain and brain tissue loss are referenced here for readers who wish to explore these findings in greater detail.2-8

In any discussion or study of chronic pain complications, the question about drugs—particularly opioids, as a causative factor—is naturally asked. All the studies noted above had at least some subjects who did not take opioids. To determine whether brain structural changes occur independent of opioids, Buckalew and colleagues at the Universities of Pittsburgh and West Virginia carefully studied a group of older adults with chronic pain who did not take opioids and who had none of these confounding conditions: hypertension, diabetes, major depression disorder, post-traumatic stress disorder, or a previous stroke.8 They found essentially the same altered and reduced brain matter as all of the other studies.1-7 It is also cogent to point out that long term opioid therapy has not been found to produce significant decreases in neuro-cognitive abilities.9,10 In fact, adequate pain relief may improve them.9

Not only have scans and magnetic imagery documented the loss of gray matter, a number of other studies complement these findings in that the brains of chronic pain patients demonstrate altered neurochemistry and central nervous system processing of input signals such as odors, taste, heat, emotions, and touch.11-16 Studies show that chronic pain patients do not process external stimuli in a normal fashion.11 Patients with chronic back pain have altered dopamine and opioid availability in the forebrain.17,18 Fibromyalgia patients appear to have a reduction in the receptor availability of dopamine and opioid mu-receptors in parts of the forebrain.19,20 In summary, it appears that brain neurochemicals important for pain modulation are not responding as they do in healthy individuals.11-20



http://www.practicalpainmanagement.com/pain/other/brain-injury/brain-atrophy-chronic-pain-call-enhanced-treatment

Much more info at the website.

[indepat]

16. Ironic reading this article on the day after the administration has made it very difficult, if not

impossible, for the bed-ridden with permanent chronic pain to legally get their critically-needed pain medication. Thanks to the administration for not thinking the concept of permanent chronic pain through. This ruling is tantamount imo to cruel and unusual punishment to a class of people who heretofore might have committed no crimes, but who now might be driven to the street to acquire critically-needed medication to alleviate chronic pain. P.S, Uncle Sam, how many die needlessly in America each year due to the lack of sensible laws to restrict the ownership/availability of military-grade weapons of near mass destruction?

[UglyGreed]

19. This is why I posted

this thread. It seems the only ones who care are the ones who suffer.