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  • Yes, I Said it. Chronic Pain is in Your Head (but Not the Way You Think)

    People with chronic pain are often accused of being hypochondriacs, being told that their Chronic pain and fatiguepain is all in their head. Well, I’m here to tell you… that’s true. Before you bite my head off, though, hear me out. I’m on your side!

    You see, when you have chronic pain changes take place in the brain that change the way your body processes pain signals. And these changes happen regardless of whether your pain began as an illness, an injury, or has an unknown cause.

    Here are just a few examples:

    • All the “wiring” needed to experience pain is located in the brain. OK, this isn’t a change, but it does set the framework.
    • Pain makes it more difficult to sleep, which leads to an increase in fatigue, a decrease in pain threshold (meaning less pressure, heat, etc. hurts you more than it does a “healthy” person), and that leads to an increase in pain
    • fMRI (functional Magnetic Resonance Imaging) studies have shown that the brains of people with chronic pain have more activity in the pain processing centers at the same stimulus level. Most studies used heat, so a lower temp caused greater activity and therefore greater pain response in those with chronic pain than in the healthy controls.
    • There is decreased blood flow to the hypothalamus, the brain’s key coordinator for pain processing. Since blood carries nutrients and energy to the organs and cells of the body, this means that the hypothalamus has less energy to process the pain signals in your body and coordinate an adequate response.
    • One area of the brain is involved with both verbal fluency and pain processing. So, when pain goes up, your ability to find the words you want or stay focused on what you’re saying goes down.

    There was a great article on last month titled Cognitive dysfunction and fibromyalgia. It summarizes several studies in everyday, easy to follow, don’t-have-to-be-a-scientist-to-understand-it language. If you or someone you know has chronic pain, I encourage you to read it.

    So, the next time someone insinuates, or comes right out and says, that your pain is all in your head, you can smile politely and say, “Yes it is, and an fMRI can prove it.”

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