UPDATING FACTS ABOUT PAIN

What is pain, and why do we feel it?:

It’s a simple question but the answer has changed dramatically over the past 10 years. Thanks to brain imaging technology, scientists now have a lot more information about how pain is processed and why it becomes chronic. Unfortunately, it takes a long time for advancements like this to trickle through the healthcare system and the education system. So unless you’ve been reading the latest medical journals in your spare time, it’s likely you haven’t had the opportunity to learn about these newer insights into pain yet. It’s important to update your facts, and if you are one of the millions who experience chronic symptoms, it’s important to do this for two big reasons:

1. A lot of what we used to believe about pain is no longer accepted as true. This could help explain why some of the pain management strategies that you’ve tried in the past haven’t worked. It’s possible those strategies are based on outdated information.
2. Some of the information that scientists are learning about pain is actionable. It includes research on specific at-home strategies that you can apply directly to your situation today.

“Pain is not a purely physical experience,
as it was once believed to be”

The first big finding is that pain is not a purely physical experience, as it was once believed to be. Today, scientists view pain through what’s called a “biopsychosocial” lens. If you look in the Journal of Pain, you’ll see that this is a perspective where pain is viewed as “a multidimensional, dynamic interaction among physiological, psychological, and social factors that reciprocally influence each other.” ¹  That’s a mouthful, but the idea behind it is simpler than it sounds. It means that pain is not just a product of an injury or a virus in the body; it’s an experience that’s reflective of what’s going on in your body, your mind, and your environmental or social context. All of those factors matter, and they all influence one another in our experience of pain. You may be wondering how this works, and how factors like your thoughts and social beliefs could possibly influence the experience of a very clearly physical symptom.

“Pain is not necessarily processed in the location of the body
where you feel it, it’s processed in the brain and the nervous system”

This brings us to the next big discovery in pain science. Pain is not necessarily processed in the location of the body where you feel it, it’s processed in the brain and the nervous system. As you already know, this is also where all of our psycho-social information is processed. This is true for every type of pain, whether it’s an aching back, a migraine or a broken leg. Even when pain is triggered by tissue damage, the pain response doesn’t come from the tissue itself, but from the nervous system. That being said, the nervous system can and does receive input from pain receptors in the tissues of the body, which are called nociceptors. But this nociceptive information is only one of the many factors the brain takes into account when deciding how much pain to produce, where, and for how long. That’s why two people can suffer an identical injury, but have a completely different experience of pain.

“The way that YOUR nervous system produces and responds
to pain is unique to you, and it can change over time”

This brings us to our third big advancement in pain science. The way that YOUR nervous system produces and responds to pain is unique to you, and it can change over time. Your brain and nervous system learn how to respond to various stresses through EXPERIENCE, through your thoughts and fears and feelings. Pain is one mechanism that the brain uses to keep you safe, and it uses all of these factors to learn how to do better job over time. So this is where the “psycho” and “social” come into play: they have a huge role in configuring your brain and nervous system to its default setting of how it uses pain. ²  In people with chronic pain, the nervous system has often programmed itself to a hyper-sensitive, overprotective setting, which means that it produces increasingly painful responses to fairly normal stresses and stimuli over time. The evidence to support this comes directly from brain imaging studies, which have shown evidence of alterations in brain structure as well as function among patients with chronic pain. ³

At first blush, that sounds scary and irreversible. But it’s actually quite the opposite. This means that for the first time, we can see what changes are taking place in the brain as pain becomes chronic, and now, we can finally do something about it.

” The brain and nervous system can
always be re-programmed”

This brings us to some very good news, and our fourth major advancement in understanding pain. The brain and nervous system can always be re-programmed. They remain plastic throughout our lives. So even though changes have already taken place in the brain as pain becomes chronic, many of these changes can be reversed, sometimes completely. So if you identify and resolve some of the factors that have sent your nervous into a hyper-sensitive setting, you might be able to decrease how frequently or intensely your nervous system triggers a pain response.  One of the most effective methods that’s been found to reverse these brain changes really simple: focus on learning cognitive, behavioral, and psychological techniques. ⁴ ⁵ This can take many forms, but to give you an example of how it works, you could use these sorts of techniques to calm down your brain’s fear response during a flare-up, or in more technical terms “reduce catastrophizing.”  To quote the conclusion of one such study led by Robert Edwards from Harvard University:  “…psychosocial and behavioral interventions that target cognitive processes have been shown to reverse these functional and structural brain changes over the course of just months. Collectively, these findings substantiate the possibility that interventions that reduce catastrophizing and negative affect may produce long-lasting, adaptive shifts in brain processing of pain.” ¹

In short, this means that there is more hope for chronic pain patients today than ever before. For the first time, people in pain don’t have to wait for new pills or surgical procedures to start finding more control and in many cases relief. There are safe, effective techniques that can address your pain from a different angle, help you to re-program your nervous system, and start turning down the volume on your symptoms, no matter how they started or how long they have lasted. The only way to know how much of a difference this information can make in your life is to start applying these techniques and see what happens.

MBS/TMS Lecture

Mind Body Syndrome/Tension Myositis Syndrome

This lecture given by Dr. Schubiner is offered to the public for viewing to help understand how the mind and the body are intricately related. The more we understand about how pain (which of course is real) can be caused by stress and strong emotions (even at times when we are unaware of having such emotions, the better we will be able to understand ourselves and rid ourselves of chronic pain and other symptoms. The lecture is divided into four 15 minute segments. (part one, part two, part three, part four) Hopefully, it will help you understand how the Mind Body Syndrome (or Tension Myositis Syndrome) works and if it applies to your situation.

Part 1

Dr. Schubiner’s Mind Body Syndrome Lecture

Part 2

Dr. Schubiner’s Mind Body Syndrome Lecture

Part 3

Dr. Schubiner’s Mind Body Syndrome Lecture

Part 4

Dr. Schubiner’s Mind Body Syndrome Lecture