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WHEN pain lasts for three months or longer, it is classified as chronic, a condition that affects more than 30 per cent of the world’s population.
Chronic pain was long believed to be a stubborn version of acute pain – which passes in less than three months once the damage is healed – and it was treated in much the same way. Yet an increasing body of research has led doctors to believe that chronic pain should be treated as a disease in its own right, rather than an enduring symptom of tissue damage or physical trauma. This could have major implications for the treatment of lasting pain, together with the way we prescribe addictive opioids.
Recent research has revealed that in some people, chronic pain is a problem with the brain. An injury can lead to pain that persists after the tissue has recovered because the brain has rewired itself and learned to send pain signals, despite there no longer being a reason. Known as central sensitisation, it is as if the volume has been turned up on pain.
One way this seems to occur is when the brain experiences pain without relief for an extended period. “The brain interprets tissue damage and misfired pain signals exactly the same way,” says Alan Gordon, director of the Pain Psychology Center in California. “[The pain is] all equally real and equally valid.”
To help deal with the issue, Gordon has developed a talk therapy called Pain Reprocessing Therapy (PRT), which involves shifting people’s beliefs about the causes and threat of pain (see The new pain treatments that may finally stem the need…
