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Understanding Chronic Pain – Part Two

November 4, 2014 by Dr. Sealander

In part one we discussed the different components of a pain experience, the role fear can play in pain and how your brain prioritizes your pain experience based on different contexts.

Another phenomenon that is highly characteristic of chronic pain is called central sensitization. Basically, the more frequent a certain neural pathway is stimulated, the stronger that pathway becomes. Just like learning a skill, the more you repeat that skill the easier it becomes and the more efficient your nervous system becomes at it. Unfortunately, this is equally true for pain. What this means is, the more you hurt, and the more you aggravate an injury, the easier it becomes for that neural pathway to make it to your brain and be perceived as pain. As this happens, and these pathways in your central nervous system become more efficient it now takes a smaller amount of a stimulus to provoke the same amount of pain. Now all it may take is simply bending over to produce a pain experience where as before you had to bend over and lift a heavy object. This increase in pain can take place completely independent of any changes within that particular body part.

As these changes take place it becomes more and more difficult to move without pain and more difficult to find relief. Now, the subjective (emotional) component of pain starts to really set in. Feeling like you don’t have control over your situation, not understanding what’s going on and fear of being disabled can all drastically increase your pain experience and it’s extremely common for chronic pain patients to become depressed for these very reasons.

 

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