There is no doubt that chronic pain changes a person; the physical and emotional effects are often readily apparent. Yet a less well-known, but equally serious effect of pain is that it actually changes the brain, causing emotional and cognitive impairment and deficits that can further hinder your ability to live a full and rewarding life. Fortunately, recent studies have shown that with effective treatment for pain, our brains can heal along with our bodies, resulting in a restoration of brain functioning.
Altered Brain Morphology
Chronic pain doesn’t just affect a singular region of the brain, but in fact results in changes to multiple important regions, which are involved in many critical functions and processes. Various studies over the years have found changes to the hippocampus, in addition to reduction of gray matter in the dorsolateral prefrontal cortex, amygdala, brainstem and right insular cortex, to name a few.[1][2][3] A breakdown of some of these areas and their related functions may help to put these cerebral changes into context.
Hippocampus
The hippocampus is part of the brain’s limbic system, which helps regulate emotional responses.[4] Particularly, it is thought to be associated with the formation of new memories relating to facts and events, and spatial processing, or your brain’s ability to map the layout of your environment.
In a 2012 study, researchers found that those experiencing chronic back pain and complex regional pain syndrome (CRPS) had “significantly less bilateral hippocampal volume.”[1] They concluded that this may be associated with both learning and emotional deficits.
As part of the study, the team completed several tests on mice with and without chronic pain. The results showed that mice with pain experienced both increased fear and anxiety when compared to mice without pain. This was due, in part, to their inability to properly form memories relating to context, in addition to a generally increased fear of unfamiliar situations. The decreased hippocampal volume is likely to cause similar effects in humans, particularly increased anxiety and both learning and memory problems.
Bilateral Dorsolateral Prefrontal Cortex
Chronic pain, specifically low back pain, has also been found to decrease the gray matter in an area in the brain known as the bilateral dorsolateral prefrontal cortex (DLPFC). This area, located in the front of the brain, is responsible for what are known as executive functions,[5] like the ability to remember past events and use them to help you act in similar situations in the present, and the ability to assess and adjust your actions based on the their outcomes.
In a 2011 Journal of Neuroscience study, they found that although the decreased DLPFC did not hinder people’s ability to complete tasks, it did change the way their brain reacted when faced with a challenge. Essentially, those with chronic pain had to use more of their brains to complete the exact same task. In other words, pain makes it more difficult for the brain to process information and problems.
Reversible Changes
Pain’s effects on the brain may seem overwhelming, but there’s good research to suggest that the changes are not permanent; they can be reversed when patients receive treatment for their painful conditions. “Gray matter abnormalities found in chronic pain,” a 2009 study concluded, “do not reflect brain damage, but rather are a reversible consequence … which normalizes when the pain is adequately treated.”[3] The 2011 study concurred, suggesting that “treating chronic pain can restore normal brain function in humans.”[2]
Seeking effective pain treatments, like those offered by professional practitioners, can not only reduce pain levels, but also improve your cognitive functioning. Less pain, better emotional responses and improved cognitive function are all at your fingertips. Why wait?
References
[1] Mutso, A. A., D. Radzicki, M. N. Baliki, L. Huang, G. Banisadr, M. V. Centeno, J. Radulovic, M. Martina, R. J. Miller, and A. V. Apkarian. “Abnormalities in Hippocampal Functioning with Persistent Pain.” Journal of Neuroscience 32, no. 17 (October 25, 2012): 5747-756.
[2] Seminowicz, D. A., T. H. Wideman, L. Naso, Z. Hatami-Khoroushahi, S. Fallatah, M. A. Ware, P. Jarzem, M. C. Bushnell, Y. Shir, J. A. Ouellet, and L. S. Stone. “Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function.” Journal of Neuroscience 31, no. 20 (May 18, 2011): 7540-550.
[3] Rodriguez-Raecke, Rea, Andreas Niemeier, Kristin Ihle, Wolfgang Ruether, and Arne May. “Brain Gray Matter Decrease in Chronic Pain Is the Consequence and Not the Cause of Pain.” Journal of Neuroscience 29, no. 44 (November 04, 2009): 13746-3750.
[4] Yassa, Michael A. “Hippocampus.” Encyclopedia Britannica Online. 2016. Accessed March 10, 2016. http://www.britannica.com/science/hippocampus.
[5] Miller, Bruce L., and Jeffrey L. Cummings. The Human Frontal Lobes: Functions and Disorders. New York: Guilford Press, 1999.
