Having chronic pain is tough both physically and emotionally. Pain at times seems to control your life. In reality, one needs to become the captain of the ship and take control of your pain and your life. Everyone has problems in life, but if you deal with pain, you need to learn how to manage it and move forward with life. Do not wallow in pity and do not expect others to suffer with you. Taking control of your life involves managing your pain and your emotional status. It also means not using pain as an excuse for doing nothing in your life.
Pain is complex. Once it is chronic, it may be functioning independent from the original cause. It also may be due to constant stimulation of the pain sensors in the body and develop into a central sensitization type of pain status. Over time, the brain may become overly stimulated by pain reception, and in a practical sense, a short circuit develops in pain reception and the brain is overwhelmed by the pain signals.
The Brain and Pain
One of the main functions of the brain is to perceive and interpret all the signals it is receiving. There are conscious and subconscious levels on which the brain translates signals. Some sensory impulses are translated on a reflex level without significant interpretation, while others have extensive cognitive and emotional components. A person has tremendous cognitive control over many aspects of brain function, including the power to modify the meaning of pain signals. The brain can choose to ignore pain signals, especially when they are the chronic background pain signals.
The brain perceives unpleasant sensations in the body. The perception of direct pain signals from painful sensory stimulation can be considered as primary suffering. Overlaid upon this are the feelings, emotions and memories associated with the pain. The feelings associated with pain lead to anxiety, stress, depression and are the secondary suffering felt by a person. Over time, the primary suffering may be minimal and the secondary suffering becomes the major component of pain.
Anxiety and Stress
After years of practice and noticing that pain seems to never improve in the patients who have high anxiety, stress and depression, science has actually helped explain the problem. Using special functional MRI scans of the brain, a psychologically normal person with acute pain has only a couple areas in the brain that enhance. A stressed, depressed and anxious person with pain will have multiple areas of enhancement and abnormalities on a functional MRI scan. Other studies have also shown a normal person exposed to pain can endure much more stimuli, and those who are already stressed have a much lower threshold to similar stimuli. Thus, anxiety, stress and depression have a very negative impact on pain control.
The next level of research that has been done has been focused on treating the anxiety, stress, emotions and depression in the pain patient. A variety of techniques have been used to decouple suffering and treat these components of pain. Techniques have included mindfulness, hypnosis, cognitive behavioral therapy and medications. When the emotional secondary suffering has been treated, often the physical perceived pain can almost be eliminated.
Different people will respond to a variety of techniques. Most people who have chronic pain do have emotional suffering components to their pain. Treating the emotional suffering often becomes more important to solving pain control issues as time passes than finding traditional medical interventions. Further, most people are in denial of any emotional components of pain. However, when the patient is withdrawing from activities of life, it is evident to everyone around the pain patient that there are components of emotional suffering.
When pain becomes an excuse not do something, and one starts withdrawing from life, you are emotionally suffering. Stop asking for pity. At this point, you need to find your solution to your psychological problems and get help to solve them. Solve the psychological issues, and it is amazing how much better the chronic pain issues become. The patients who have a healthy psychological status function and move forward in life. These are also the people who do not make excuses for themselves and have very little dependence on addictive substances. If the stress of life is affecting pain, then get help and find the solution that helps you treat and eliminate the negative behaviors in your life. Stop making excuses and start moving forward in treating the right problems, your stress, anxiety, and emotional well-being.
Thomas Cohn, MD
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