For Chronic Pain Sufferers, It’s All In Your Head

The state of your brain may determine whether an injury heals or the pain persists.

A new study suggests that chronic pain is, quite literally, all in the sufferer’s head.

Researchers at Northwestern University’s Department of Medicine found that the state of the brains of people who have suffered the same injuries plays a role in whether each person recovers or develops chronic pain.

Approximately 100 million Americans suffer from chronic pain, according to the Institute of Medicine of the National Academies. That’s compared to 25.8 million who have diabetes, and 11.9 million Americans who suffer from cancer.

In a study involving 40 patients with back pain, brain scans showed that those who were more likely to have chronic pain experienced more communication between two areas of the brain: the frontal cortex and the nucleus accumbens, which deals with emotional and motivational behavior.

“For the first time we can explain why people who may have the exact same initial pain either go on to recover or develop chronic pain,” said A. Vania Apakarian, the study’s author.

In particular, the brain scans revealed that the more emotionally the brain reacted to the back injury, the more likely the pain endured after the injury already healed. “It may be that these sections of the brain are more excited to begin with in certain individuals,” Apakarian said. Genetics and environmental influences may also play a role in the individuals’ brains.

What the results means for sufferers is that the two areas in the brain are telling the rest of the brain to develop chronic pain. The nucleus accumbens, in particular, teaches the brain how to evaluate and react to the outside world. Apkarian suggests that it may be sending out a pain signal to the brain to develop lasting pain.

Based on the findings, Apkarian says new therapies may be developed to treat chronic pain, which affects 1.5 billion worldwide and typically increases with age.

The study is published in the journal Nature Neuroscience.