The link between chronic pain and brain functioning

Chronic pain and chronic illnesses have a severe impact on our physical health. It alters our lifestyle and the way we function. However, it has immense effects on the brain and it’s functioning as well. In an interview with HT Lifestyle, Dr Pradyumna Oak, Director, Neurology, Nanavati Max Super Speciality Hospital, pointed out the connection between chronic pain and brain functioning – “Little did we know that the chronic pain affects not just our body but also the brain. 

In some cases, it may also lead to specific changes in its structure and function. Recent studies have highlighted how chronic pain conditions like back pain, fibromyalgia, and complex regional pain syndrome (CRPS) can cause specific alterations in shape or structure of the brain. These changes often manifest in regions associated with pain processing, such as the cingulate cortex, insula, and prefrontal cortex.”

Brain signature:

Patients with chronic pain show distinct ‘brain signatures’ related to their condition. For example, chronic back pain or fibromyalgia patients tend to show a decrease in gray matter (brain’s outer layer where most brain cells are located) in the insula and secondary somatosensory cortex. This reduction in gray matter is due to the brain’s ability to reorganize itself, known as neuroplasticity. In chronic pain, this reorganisation occurs in ways that unfortunately strengthen and perpetuate the pain experience, making it harder to treat the condition and reduce the pain sensations.

Change in brain chemistry:

Chronic pain is also linked to changes in brain chemistry and function. It only means that pain can change both the brain structure and connectivity. Chronic pain patients often show enhanced connectivity between the areas of the brain responsible for emotion and motivation. This means that chronic pain affects not only the pain sensations, but the thoughts and the perception of pain of the patient as well.

Brain changes are not permanent:

Interestingly, these brain changes are not permanent. Effective pain management techniques can partially reverse some of the structural changes in the brain. This highlights the brain’s amazing ability to adapt. Therefore, early and effective pain management is crucial to prevent long-term brain changes.