Newsletter

Current News   |   Newsletter

The Complexities of Chronic Pain: Loss, Treatments and Hope

by Julie Roberts

Pain is the brain’s way of telling us that something isn’t quite right in the body – and it’s something that we all experience. But it isn’t as easy to understand the brain’s role in generating and withstanding pain. For people who suffer from chronic pain – the kind that lasts more than a few months, sometimes with no obvious cause – unlocking the mysteries of these problems is especially important.

There are a few things that we do understand. First, we know that pain does cause harm to the brain. “Functional neuro-imaging studies have recently confirmed that unremitting pain damages the brain—and in some cases, the damage is irreversible,” says Dr. Perry Fine, a professor of anesthesiology at the University of Utah’s Pain Research Center, and a Brain Institute member.

And ironically, the brain produces pain. Dr. Yoshio Nakamura, Brain Institute member and research assistant professor of anesthesiology at the Pain Research Center, explains, “Pain is created by the brain. That’s why the work done at the Brain Institute is so helpful.”

We also know that people who have chronic pain can experience losses – including jobs, relationships, and lifestyle options. But they may also endure the greatest damage of all: the loss of self.

As Dr. Susan Connor, a clinical psychologist at the University Neuropsychiatric Institute,describes it, people facing the prospect of a life filled with pain – and the loss of their prior healthy selves – experience a period of bereavement complete with all the classic stages of grief, including denial, anger, bargaining and depression. The final stage, acceptance, isn’t easily won – and it can be fleeting. “Accepting the new life with chronic pain is cyclical – you might accept it at one time, but then when your pain flares up again, you
have a difficult time with acceptance,” says Dr. Connor. “Chronic pain can be very disruptive.”

While there are no easy solutions to the complex problem of chronic pain, researchers at the Brain Institute and the Pain Research Center are collaborating to find new answers. Current advances
in pain research and treatment include:

Pain-Specific Medications

Pain-relieving medications aren’t always effective in easing each person’s very specific pain symptoms. However, new technology may change that. Dr. Nakamura says that pharmaceutical companies are developing medications that can respond to different types of pain. These new medications will allow doctors to analyze their patients’ pain and prescribe appropriately, and as a result, “Different types of pain can be alleviated differently.”

Meditation

Meditation has been used for many years to address a wide range of ailments, and now it’s proving to be effective as a pain management technique too. For example, Dr. Nakamura has seen “a huge
change” in people who use meditation to address their pain. “It’s not that the pain goes away, but people learn to handle it better. Their relationship to the pain changed.” Another perk to meditation is
that it can help to improve other parts of your life as well. Dr. Nakamura says that generally the people in his meditation study “are functioning better, relating better to family members, and doing better at work.”

Acupuncture and Stimulation

Dr. Ted Stanley, an anesthesiology professor at the University of Utah and a leading pain researcher, identifies “many advancements in pain therapy that may eliminate the need to use drugs at all.” He further explained that “nerves are like wires, and the brain impulses are conducted through the nerves. Opiates interrupt or cut the ability to feel the pain. But new, non-opiate techniques are being studied that may accomplish the same thing, including non-chemical alternatives – acupuncture, electrical stimulation, and magnetic stimulation.”

All of these treatments emphasize the importance of understanding the intricacies of the brain. As Dr. Stanley emphasizes, “We’re fortunate that we have the Brain Institute. The coordination and communication among different disciplines will help us to
understand the brain better.”

With this enhanced understanding of the brain, there is always hope that chronic pain patients will be able to regain some sense of the healthy self that they have lost. According to Dr. Stanley, “Every year – every day – there are new discoveries in pain therapy treatment. Not all will be successful, but some will be. The secrets of the brain are being discovered.”

About the University of Utah Pain Research Center

The University of Utah Pain Research Center develops multidisciplinary programs to study and treat
pain. Formed at the University of Utah in 2001, the center’s faculty includes psychologists, sociologists, biostatisticians, and biomedical engineers, several of whom are also Brain Institute members.

Next: Pain Treatment vs. Addiction