Advances in brain imaging technology stand to be revolutionary for the field of chronic pain treatment. Many common chronic pain conditions, including back pain and fibromyalgia, are steeped in mystery. The ability to monitor blood flow and grey matter volume in patients’ brains may prove revelatory for pain patients and the medical professionals trying to treat them.
While studies into this area are fairly new, there are enough to suggest that patients with fibromyalgia generally exhibit certain brain patterns conducive to chronic pain, including high rates of insula activity indicating strong anticipation of pain. Higher levels of anticipation marked by insula activity are correlated with higher pain intensity. Recently a study sought to tell whether patients with osteoarthritis, another chronic pain condition, exhibit similar changes in the brain.
The researchers found that osteoarthritis patients did have increased pain intensity proportionate to insula activity as fibromyalgia patients did, although, in osteoarthritis patients, the increase in insula activity was less marked.
Another finding of this study was that both pain groups exhibited decreased activity within the dorsolateral prefrontal cortex, an area of the brain involved in many functions, including mood regulation. Patients with low dorsolateral activation showed poor psychological coping skills. This is worrisome, since anxiety and depression are correlated with pain and disability.
See more on the study at onlinelibrary.wiley.com.
None of this is to say that chronic pain is “all in your head.” Whether the cause of your pain is in your brain or not, though, the brain is definitely involved in perpetuating the pain. Incorporating treatment methods that target these areas of the brain may be a crucial component, if not of resolving pain completely, at least of lowering its intensity. With this comes improved quality of life and lower levels of disability, which can lead to improved emotional and psychological well-being, which, in turn, can lead to less pain, and so on. Psychotherapy may be your ticket to starting this positive cycle.
Two treatment options for changing the way your brain works are meditation and cognitive behavioral therapy. Mindfulness meditation may be especially helpful to chronic pain patients, as it trains you to observe and experience what is happening within your body without immediate judgments or assessments, such as, “Oh, man, this pain will never go away.” Research into meditation shows marked brain changes, including increased activity within the dorsolateral prefrontal cortex, meaning it may improve coping skills. See more on this at www.ncbi.nlm.nih.gov.
Cognitive behavioral therapy (CBT) is a form of short-course talk therapy in which a patient works out his or her beliefs, attitudes and thoughts concerning his or her pain. This therapy equips patients with the ability to identify negative, counterproductive thought patterns and replace them with more accurate and productive ones. One small study found CBT to increase the amount of grey matter in the dorsolateral prefrontal cortex of the brain. See more on this at www.ncbi.nlm.nih.gov.
The above studies are small and, as said before, research into brain activity in relation to pain is quite new. However, the results of the research that has been done are promising. Given the positive outcomes many patients have had with meditation and CBT, and considering the fact that these forms of therapy are risk-free, it is safe to say that they are worthwhile chronic pain treatment options.