I feel this study that came out of Australia has some important lessons for us to think about for our coping with chronic pain and that is why I felt the need to mention it. As well as some previous research I remember coming across.

Chronic pain: Changes to the brain

Chronic pain can change the way your brain processes emotion, scientists find

It was a small study, as scan studies tend to be, where they looked at the brain scans of 19 individuals with nerve pain and jaw disorders compared to the scans of 19 healthy individual control subjects.

The main finding is that those with chronic pain had lower levels of glutamate which is an important chemical messenger between brain cells that helps regulate our emotions.

What this means for us is pretty important:

“[It] means their brain cells can no longer communicate properly and therefore their ability to process positive emotion is jeopardised,” Associate Professor Gustin said.

As a result, people in chronic pain can have personality changes where they are “prone to feeling tired, unmotivated and constantly worrying on a daily basis”, she said.

You can see how these results are pretty important to our coping with pain when we already have to deal with being tired, unmotivated and worried. Unmotivated is the one in particular that concerns me. We need motivation for many of the daily things we need to do to cope and it is extremely hard to muster that up. And one does wonder why that is.

The researchers found that the greater the decrease in glutamate the more chronic pain people showed pessimism, fatigue, fear, and sensitivity to criticism.

And I know fatigue can be something that is immensely difficult to deal with. As is fear when it comes to fear of activity or fear of the future. And we do tend to constantly fight a pessimistic attitude and we are very aware of that.

Clearly, they want to see these results replicated in a larger trial.

However,

“We know that almost half of people with chronic pain have mental health conditions such as depression and anxiety and these findings may well be an explanation,” she said.

“The research could help change the way we understand and respond to chronic pain.”

There has been previous research on motivation

That motivation thing and what to do about it and it references a study done on mice that showed a disruption on the reward system of the brain. The mice with chronic pain, even treated, had no motivation to seek the reward they knew was there. And maybe there is a connection. The chronic pain was causing more than just lack of motivation but also fatigue, fear, and pessimism… they just gave up on that reward.

When you think of chronic pain and motivation with these issues:

It makes sense and it explains a lot. Chronic pain makes living life and doing things a Momentous effort. And it does seem that our own brains are constantly sabotaging us. And one way is the motivation problems we can have… like we have to Force ourselves to Do things and hope that will eventually give us our motivation back… but it never does. Instead, we are constantly exhausted… just all the time and everything seems like so much damn effort.

And that compromises our capacity to cope and manage chronic pain. We may have a routine of things that help us cope… but it never becomes a routine because motivation lacks so much or fatigue is just so intense. It is a struggle to do the things we know make us feel a little bit better, even though we Know those things help. And that makes our mood suffer. Why can’t we just Do the things we need to Do that help us feel better and cope better? Well, don’t knock yourself… our brains, apparently, are just not helping us in this.

So I do believe the research is onto something. We know already that chronic pain isn’t just pain. It comes with symptoms as well.

effects of chronic pain.png

So consider all that when you are trying to cope and set up routines and habits to help you cope. It is a challenge. We will falter from time to time. It is going to happen and we shouldn’t feel guilty about that, just try again the next day. It takes a lot to fight our brains on this and deal with the chronic pain at the same time.

What it essentially boils down to is that chronic pain is complex and difficult to manage. Difficult to treat as well. And one of the reasons why is that these other symptoms do not help us with struggling to engage in our own treatment but rather compromise it. And it can be a real struggle for us to stay on the track we want. Or feel like we are getting any results at all. That pessimism we can have can make us halt any treatment believing nothing works or will ever work. I have been there. However, that was because I had that pessimism, the fatigue and depression rolled into one. And yeah it felt futile. And at those times it does seem like a break from ALL that is the best I can even do. But eventually, I get some motivation back to find the energy to work at different coping strategies and develop new habits and routines to help me cope. Hoping I will not compromise my own coping again, knowing it is very possible I will. Sometimes the best we can do is just cope the best we can when we can.

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22 thoughts on “Chronic pain: changes to the brain

    1. And we shouldn’t feel so bad about it really. Not when it is a consequence of chronic pain in the brain. It is literally something we have to fight against like everything else. And man what a hard thing to have to deal with… when you Don’t feel like it.

      Liked by 1 person

  1. That’s interesting I feel like that’s the reason my yoga routine has fallen away. I don’t practice daily as I used to but being in more pain after yoga even if it makes me feel better later on for my mind is just not reward enough anymore.

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    1. I agree with that. I am the same with exercise. In the long run it helps. But it quite hurts for that day and is fatiguing as well. And No endorphins for Sure. So even wanting to is difficult. I have to force myself to. And doing that tends to make it not a routine because any sort of bad day and no way I am forcing myself to make it worse

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  2. Found this really interesting, thanks for posting. My parents (who are of a different generation and struggle to understand my disabilities despite supporting me amazingly when I was a kid) often say to me things like ‘we’re worried this flare/increased pain is going to affect your head again or make you ill’ Obviously! 🙂 The flare and pain impacts my routine, disrupts my social life, knocks my confidence and means I’m that much closer to the end of my rope to deal with other things that life throws up. I’ll show this to them, especially that ‘Symptoms of Chronic Pain’ graphic 😉 Keep up the good work.

    Liked by 1 person

    1. I agree with you there each time I have a downturn it throws everything out of whack… including my confidence and self-esteem. But it is good to know some of this we deal with is pain itself affecting us … not that it changes the fact we have to cope with the consequences of it

      Liked by 1 person

  3. Hi Nikki, interesting post. I’m a longtime sufferer of chronic pain and a great believer in how our brain controls not only pain but the associated emotions that go with it. The brain is all connected by biochemistry (chemical brain messengers as you have stated.) That’s why I’d like to add medication to your topic.

    All kinds of side effects can happen with long term medication including addiction and depression, one fostering the other. Sadly as is the trend today, most of us long term chronic pain sufferers are now or have been addicted to pain killer prescriptions that also effect ones motivations and emotional well-being. Now our issues are two-fold!

    Sadly unless brain research finds a chemical constant involved in chronic pain (as you have exampled) I’m afraid the only answer is, as you have stated — to cope the best you can. True chronic pain is a life changing never-ending battle that’s usually fought internally and alone. Here’s hoping that one day brain research will provide an answer.

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  4. This is interesting. I wonder if there is more research going into supplementing with glutamate to combat the depleted levels? I’ve been battling chronic pain for the last couple of years and every medication I tried made it worse. I recently got to the point of accepting that there was no option for me but to cope, and it’s slowly starting to get better, but it takes a lot of mental discipline. I recently wrote about it on my blog – a piece called “The Hardest Mountain”. I came to a lot of the same conclusions you did. Thanks for posting!

    Liked by 1 person

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