New article, does it give the wrong impression?

[Mark N]

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The emotional state of the brain can explain why different individuals do not respond the same way to similar injuries, say scientists.
Some recover fully while others remain in constant pain.
Brain scan studies showed for the first time how chronic pain emerges as a result of an emotional response to an injury.
The process involves interaction between two brain regions, the frontal cortex and nucleus accumbens.
Lead scientist Professor Vania Apakarian, from Northwestern University in Chicago, US, said: ''The injury itself is not enough to explain the ongoing pain. It has to do with the injury combined with the state of the brain.

The more emotionally the brain reacted to the initial injury, the more likely it was that pain will persist after the injury has healed, he said.
Prof Apakarian added: ''It may be that these sections of the brain are more excited to begin with in certain individuals, or there may be genetic and environmental influences that predispose these brain regions to interact at an excitable level.''
The research involved 40 volunteers who had all suffered an episode of back pain lasting one to four months.
Four brain scans were carried out on each participant over the course of one year.
The results, published in the journal Nature Neuroscience, made it possible to predict with 85% accuracy which individuals would go on to develop chronic pain.
The nucleus accumbens teaches the rest of the brain how to evaluate and react to the outside world.
Prof Apakarian said it may use the initial pain signal to teach other parts of the brain to develop chronic pain.
''Now we hope to develop new therapies for treatment based on this finding,'' he added.

What do you think about this article and its conclusions based on your life with CP?

[Mark N]

One thing I have noticed over the years with a variety of studies and articles that have been published is they treat CP as if it is one malady. I have to say in my experience that I see CP in different ways depending upon the cause and the intensity of the pain. Some people have pain from injuries and that pain lingers even if the injury has healed, others have CP due to a disease that is ongoing. On the other hand CP can be muscular or nerve pain that doesn't let up nor has a cure.

I always have doubts about a study when they look at CP as a common malady that all people that suffer from long term pain have. It seems to me that we are a long way away from a solution when doctors don't even acknowledge the differences in CP. These are just my ideas after suffering from CP as the result of continuing deterioration of my spinal disk.

[mrsQ]

I agree that there is flaw in the way most of these studies are done. I only took one class in experimental psychology & left it with a grateful C , so I'm no expert. However, to me it seems they pick something that they can not actually measure to compare. "40 volunteers who had all suffered an episode of back pain lasting one to four months." Back Pain can be anything from "ouch'' to laying in the floor screaming depending on the cause. And I would say that people who had a more tramatic pain to start with might have the type of damage that would cause chronic pain to.
If they want to do these studies they need to limit their test group more, compare only people who had say a herniation within a certain area of the spine. Your going to have variables with any group but the way they are doing it looks like it would be like comparing people who had a fender bender or their car flipped 3 times. Both would be people who had been in a car accident but one is more likely to suffer more physical and emotional results.

[houghchrst]

To me there seems to be a few things wrong with this. No injury is exactly the same, the causes, the scenarios for everyone are different, no one's brain chemistry is the same.

[Kathi49]

Mark, I believe they are speaking of the "pain in the brain" which I have believed in for quite some time. I don't get the impression that it is strictly ALL emotional; just that it is a combination. Anyway, since you asked, my own pain was not acute and lasted 3 years before anything was done. So, I think due to the severity of the pain my brain or rather Central Nervous System became entirely jacked up! As far as emotions go, heck yes I was afraid, afraid that I would pass out while trying to work then that led to panic attacks and vaso vagal responses. All in all, I think this article is pretty good although I do agree that 4 months of back pain isn't enough for a good study. Oh, one more thing. That poor girl that had the flesh eating bacteria was refusing pain meds (not sure for how long). But the docs evidently told her her pain would amplify. I was glad to hear (a day after reading that) that she finally accepted them. My point being...yes, there is something to this article.

[mrsQ]

Not trying to get off topic but did you see in the news today where she left the hospital to go into rehab. I'm amazed/thrilled to see her doing so well.

And your right Kathi the fear of future pain does effect our CNS, I did not think of it in that aspect when I first read it.

[Kathi49]

Yes I did and was so glad to see her able to leave. She is in for a long haul, poor girl. But she does have a positive outlook. :) I have to admit that I only read the one article in regards to the meds. She was evidently refusing them due to her own personal convictions. And honestly, I was thinking, dear God someone please explain to her that she NEEDS to take them. Evidently the doc(s) got through to her because the very next day was accepting them. And the article did use the wording of one doctor which was "amplify". I knew what it meant because it took my own Neurologist to explain it to me a long time after my own surgeries and what had occurred during those 3 very long years.

[alex44]

Hi All - nyeah - Pain sucks. Everyone is differant, in terms and symtoms. and the beat goes on - more undertreated pain, beware Suboxone, false promises by false prophets.
Hope this finds everyone well and as pain free as possible.
Blessings
Alex44
Skypilot

[Mark N]

Karen you put it very well comparing a fender bender with a wreck that flipped the car three times. Thanks for your input.

Kathi, I wasn't saying the article had nothing to offer. I am just concerned when they lump all pain patients in one group and then conclude that emotions impact pain levels. I understand that emotions do e ffect pain levels but not all pain can be attributed to emotional state and I am afraid too many come away from the article with that idea. CP is a complicated issue, after all one dr found a way to give women an orgasm when he was using electrical stimulation to eliminate pain.

Alex, good to see you and yes pain sucks.

Christina, you do have to wonder how they account for the differences in brain chemistry when they do these studies.

[Kathi49]

Mark, I understood what you meant. :) What I was saying is that I didn't come away with a wrong impression; rather that chronic pain can be linked to emotions in DIFFERENT people as the article stated. I just don't see or didn't see where they lumped everyone together. As I said, I have believed this for a long time else why does someone experience "windup", "pain in the brain", Central Pain Syndrome, Chronic Regional Pain Syndrome, etc. long after an injury has healed. Personally, I am glad they are looking into other therapies because it has the potential to help a lot of people. Anyway, there are a lot of articles about this that are really interesting to read, very informative and very technical so to say.

[suede]

My brain doesn't absorb very well any more after all these years of pain.

My intake on this study is it seems to be saying that people with emotional problems are going to react worse to pain then those that don't have a history of emotional problems or one that has suffered from say depression.

It seems to fit in to what I have had many Drs. say over the years before I was dx'ed, I feel that trials such as this one is not going to benefit those with CP how beneficial and accurate can a trial be that only had 40 people participated in.. I feel rather sure what the treatment plan will be for those that they believe suffer more from an emotional aspect of the injury.

I even had one that told me because of my abused background he felt I missed being in pain...

Linda