Effective Chronic Pain Treatment Starts With The Brain

September 28, 2023 / Thomas Cohn, MD

A new study published in JAMA Network Open suggests that targeting the brain and a person’s attitudes toward pain may be an effective method for treating chronic pain conditions.

More specifically, the study sought to influence a person’s pain attributions – which are their beliefs about the underlying causes of pain – to help reduce pain severity. For the study, a group of individuals with chronic pain underwent pain reprocessing therapy (PRT), which is a form of treatment that teaches people to perceive pain signals sent to the brain as less threatening. Researchers found that two thirds of people treated with PRT reported being pain-free or nearly pain-free after treatment. Only 20 percent of people in the placebo group said the same.

“Our study shows that discussing pain attributions with patients and helping them understand that pain is often ‘in the brain’ can help reduce it,”said the study’s first author Yoni Ashar, Ph.D., assistant professor of internal medicine at the University of Colorado Anschutz Medical Campus. “This study is critically important because patients’ pain attributions are often inaccurate. We found that very few people believed their brains had anything to do with their pain. This can be unhelpful and hurtful when it comes to planning for recovery since pain attributions guide major treatment decisions, such as whether to get surgery or psychological treatment.”

Pain And The Brain

Researchers concluded by saying that it is important for chronic pain patients to really try to better understand their pain and how their brain is processing pain signals. Prior to PRT treatment, only 10 percent of participants viewed their chronic pain issue as something that was due to a mind or brain process. After PRT therapy, that number increased to 51 percent. The study found that the more participants shifted to viewing their pain as due to mind or brain processes, the greater the reduction in reported chronic back pain intensity.

“These results show that shifting perspectives about the brain’s role in chronic pain can allow patients to experience better results and outcomes,” Ashar said.

This study touches on something we oftentimes convey with our patients, which is that pain isn’t just a physical issue. The brain-pain connection is real, and we oftentimes need to take a step back and reframe how we think about our pain condition in order to give ourselves the best chance to overcome it. It’s easier said than done, but it can be done.

If you want to learn more about your pain condition and the power of reframing how you think about pain, reach out to Dr. Cohn and his team today at (952) 738-4580.

The Science Behind Brain Development

June 8, 2017 / Thomas Cohn, MD

Your brain is the most complex organ in your entire body, and we are always striving to learn more about how it develops and the way it interacts with our body. Many people suffering from chronic pain are battling this condition due to a misfiring synapse in the brain or an issue in how the organ interprets signals it receives from other areas of our body.

Recently, a colleague from overseas at Sofia Medical University reached out after coming across the blog. He was interested in what we had written about the brain and its role in chronic pain interpretation. He asked if we would be interested in sharing an infographic that he developed that dives deeper into how our brain develops as we age. I believe it is a thought-provoking and informative visual guide, so I was more than happy to share it on the blog.

So please, check out the infographic below to learn more about the science behind our brain’s development.

Proving That Chronic Pain Isn’t Just In Your Head

July 1, 2015 / Thomas Cohn, MD

People with chronic pain often have been told it is “all in your head.” Now we can actually image brains with a combination of techniques and see actual differences in structure and chemistry that is being linked to chronic pain. The use of radioactive tracers, with PET, MRI and functional MRI scans are showing changing patterns of activity between normal people’s brains and those with chronic pain. The studies have led to several new key concepts, including glial cells and the role certain proteins play in pain expression.

Traditionally, pain has been related to signals of various nerves cell. Sensory nerve cells in the periphery of the body receive signals, then they are transmitted to the brain via the spine and interpreted by the brain, which transmits signals back to periphery. The electrical sensory and motor neurons are the critical components for understanding pain.

Now we are learning glial cells, which were thought of as structural components – the scaffolding of the nervous system – may be equally or more important in pain. Glial cells support and protect nerve cells. They also produce compounds that may control or contribute to chronic pain. As we identify the compounds, controlling their levels may be the next big discovery in managing chronic pain. One compound that is increased in chronic pain sufferers is the translocator protein. Studying the protein, one can see where glial cell activation has occurred. Using the special scans, the protein and glial cell activity can be measured, and hopefully in the near future, controlled.

Understanding the connection between pain, translocator proteins and glial cells is important to find effective treatments. Medications that may control chronic pain would decrease both translocator protein levels and glial activation. If a medication is working on these cells effectively, then the brain scans may change. As the science improves, hopefully we can use this knowledge to more fully identify the scope of problems with chronic pain and determine effective management strategies that actually work to reverse the changes and return the brain to healthier function.