Two new studies, one published last month and another slated for publication in early 2018, confirm through brain imaging and other techniques, that pain that persists long after the physical injury that originally caused the pain has healed, is a type of learned behavior that can be “unlearned” through a variety of non-medical interventions.

Source eric credit

• For a September 2017 electronic pre-print of an article to appear later this year in the journal Psychological Medicine, Yoshino and colleagues of Hiroshima University Medical School examined the resting state functional magnetic resonance (rFMRI) of both chronic pain patients and healthy controls. rFMRI, shows which parts of the brain are intrinsically connected to each other by demonstrating correlated simultaneous activity among multiple brain regions. Brain regions that are wired together typically “fire” at the same time “rest” at the same time, because one of the brain regions presumably stimulates another through synaptic connections. Thus separated regions of the brain that exhibit correlated activity are said to belong to the same “Intrinsic Connectivity Network (ICN).

Understanding Chronic Pain

• Be it back pain, headaches, joint pain, or fibromyalgia, chronic pain persists and persists. For many people, there is no end in sight. Some 30 million Americans suffer from some form of chronic pain, which is influenced by many factors, including one's emotions and memory.

• It may feel like a dull ache or even a throbbing pain. It can last months or, for some people, years. Other symptoms may include exhaustion, sleep issues, mood swings, or having no energy. Chronic pain can also lead to depression, anxiety, low self-esteem, among other issues.

• Yoshino’s research in 29 chronic pain sufferers and 30 healthy control subjects revealed abnormally high ICN connectivity within the “Dorsal Attention Network” (where consciously directed focal attention is thought to originate)—including structures such as the orbitofronal cortex and inferior parietal lobule— in chronic pain sufferers vs. healthy controls. This finding lead the authors to suggest that the brains of chronic pain suffers might rewire themselves when patients’ repeatedly focus attention on pain and/or anticipation of pain. Furthermore this rewiring could play a key role, according to Yoshino, in the continuance of pain after physical damage that caused the pain has healed.

• Neuroscientists such as Dr. Waschulewski-Floruss of Eberhard-Karls University of Tuebingen in Germany have found that “learning” of chronic pain, and re-wiring of the brain, arises through the process of classical conditioning.
  
  Source eric credit

Here's how.

• In his original experiments on classical conditioning in dogs, Pavlov noticed that dogs naturally salivated when they saw food. The food, in Pavlov’s example was an Unconditioned Stimulus (UCS) and the salivation an Unconditioned Response (UCR) to seeing the food. After Pavlov repeatedly paired the ringing of a bell with the presentation of food, the bell, even in the absence of food, became a Conditioned Stimulus (CS) that produced salivation. Salivation produced by a bell—not food--was called the Conditioned Response (CR).

• This type of learning in dogs is associated with the formation of novel neural connections, where sensory inputs from the dog’s acoustic system, which did not originally stimulate parts of the dog’s brain that triggered salivation, grew new connections (or greatly strengthened existing connections) that enable the acoustic system to stimulate salivation.

neural

• The human brain has been called the most complex object in the known universe, and in many ways it's the final frontier of science. A hundred billion neurons, close to a quadrillion connections between them, and we don't even fully understand a single cell.
• Neuroscience aims to understand how a person arises out of a clump of squishy matter. It's where psychology meets biology. And with new tools at our disposal—computer simulations, medical imaging—we double our knowledge every decade. Roll up your sleeves and poke around.

The figure below represents how an injury could lead to “learned” chronic pain, and the formation of new neural pathways (“natural” pathways are shown in blue, learned pathways are depicted in red ), even after an injury is healed.

Source eric credit

• As shown in the figure, classical conditioning of chronic pain would occur as follows: The original physical injury is an unconditioned stimulus (UCS), the original pain from the injury is the unconditioned response (UCR), the conditioned stimulus (CS) is the memory of the events (context) surrounding the injury or obsessive worries about the pain, while the Conditioned response (CR) is the experience of pain in the presence of the CS (memory of injury and/or obsessive worries about the injury).

• After pain has been “learned” in this way, a vicious circle is created, according to psychiatrist and pain specialist Joseph Hullett, in which the stress associated with anxiety about pain worsens the pain by altering the way pain control neurotransmitters such as norepinephrine and serotonin reduce pain. When pain worsens, anxiety grows worse, further increasing the pain …and so on.

Stress

• Stress generally refers to two things: the psychological perception of pressure, on the one hand, and the body's response to it, on the other, which involves multiple systems, from metabolism to muscles to memory. Through hormonal signaling, the perception of danger sets off an automatic response system, known as the fight-or-flight response, that prepares all animals to meet a challenge or flee from it. A stressful event —whether an external phenomenon like the sudden appearance of a snake on your path or an internal event like fear of losing your job when the boss yells at you—triggers a cascade of hormones, including adrenaline and cortisol, that surge through the body, speeding heartbeat and the circulation of blood, mobilizing fat and sugar for fast energy, focusing attention, preparing muscles for action, and more. It generally takes some time for the body to calm down after the stress response has been triggered.
• Lifesaving as the stress response is, it was meant to solve short-term, life-threatening problems, not extended difficulties such as daily traffic jams or marital problems. Prolonged or repeated arousal of the stress response, a characteristic of modern life, can have harmful physical and psychological effects, including heart disease and depression.
• Over the last few decades, a rising tide of studies has demonstrated the value of regularly engaging in activities that blunt the stress response, from meditation to yoga to strenuous physical activity. Since the stress response begins in the brain with the perception of stress, researchers are now looking into what may be a most basic, and effective, way to defuse stress—by changing perception of certain types of situations so that they are not seen as stressful in the first place. Studies show that helping people see certain experiences—such as final exams—as demanding rather than dire, protects them from the negative effects of stress while delivering its positive effects, especially focused attention and speedier information processing. Changing the stress mindset not only minimizes the effects of stress, studies show, it enhances performance and productivity.

What Is Anxiety?

• Anxiety, or extreme apprehension and worry, is a normal reaction to stressful situations. But in some cases, it becomes excessive and can cause sufferers to dread everyday situations.
• The exaggerated worries and expectations of negative outcomes in unknown situations that typify anxiety are often accompanied by physical symptoms. These include muscle tension, headaches, stomach cramps, and frequent urination. Behavioral therapies, with or without medication to control symptoms, have proved highly effective against anxiety, especially in children.

upvote follow resteem

@ bal-cheng