Chronic Pain is a Central Nervous System Issue

Chronic pain and other chronic symptoms are not typically the same as acute pain or symptoms. The difference being chronic stuff is more likely to be driven the brain and nervous system (CNS) vs. the local tissues like we see with acute issues. I’ve attached a 2019 scientific review article that talks about this. Below I’ve taken some quotes from the paper to show you what the research says about chronic pain. The idea is that we move from the treating the local tissues to targeting the brain in our treatment, which is something I do here at The Pain PT.

‘Chronic pain is a condition in which pain progresses from an acute to chronic state, persisting beyond the healing process. As the experience of chronic pain is associated with activity in multiple networks in the central nervous system (CNS), chronic pain is considered a CNS disorder. As a result of multi-network activation in the CNS, chronic pain comprises multiple components, including sensory, emotional, cognitive, and behavioral elements.’

‘Changes in emotion, motivation, and reward-related circuits of the brain (which encode emotional features of pain) may cause disorders associated with emotion in chronic pain conditions. A number of neuroimaging studies have demonstrated that morphological changes in corticolimbic structures and emotional systems are associated with persistent pain.’

‘Chronic pain is considered to develop as a result of the persistence of pain memory and inability to erase pain memory after injury.  Considering its importance in extinction of fear behaviors, impaired mPFC (pre-frontal cortex) activation could lead to a failure in the elimination of subcortically driven fear behaviors, thereby resulting in pain chronification.’