Yes, Pain Is In Your Brain

February 11th, 2009 · 6 Comments

A great summary article was published recently about CRPS, a pain condition with symptoms of:

burning pain
sensitivity to touch
pain in response to non-painful stimuli
weakness, tremor and muscle spasms
changes in temperature and increased sweating

If pain is felt in your body, why is it thought to be a problem in your brain?

In CRPS (and very possibly other pain conditions), changes occur in your brain to cause your “body map” to become distorted. What does this mean?

In your brain, there’s a representation of your body. Places that are sensitive - for example, your fingers – have a big representation. Places that aren’t sensitive – let’s say, your back – have a small representation. In CRPS, this “body map” becomes distorted in the areas of pain.

It also seems that the more distorted your body map becomes, the more pain you experience.

This distorted body map is responsible for symptoms such as:

errors in noticing where you’re being touched
errors in how big your body parts feels
errors in movement
touch in 1 area causing feelings in another

What this new understanding of pain provides for us is good news. Because we now better know where the problem is, so we’ve developed new treatments for CRPS.

Mirror therapy and motor imagery programs are 2 such treatments. These seem to work by reversing the changes that occur in your brain in CRPS.

6 responses so far ↓

Suber // Feb 11, 2009 at 9:44 am

I think I can understand the idea that pain is “represented” by your brain. I think that I can understand the idea that there is something in your brain that is responsible for why you feel pain in some part of your body. But I’m not so sure I understand what you mean by saying that pain is “in” your brain if by “in” you mean spatially located. If pain is spatially located anywhere, then it is spatially located in the part of the body that hurts.
How to Cope with Pain // Feb 11, 2009 at 10:00 am

What I mean is that the error/disorder/problem is located in the brain, rather than in the area of the body where you feel pain.

Many people with chronic pain think there’s still something wrong with, let’s say, their hand, if that’s where they feel the pain. But for many, the hand is actually fine. The problem is in the representation of their hand in their brain.

Some people with severe pain actually ask to have their painful body part cut off, but we now know that that wouldn’t fix the problem. Again, because the disease is in their brain.
Barbara // Feb 15, 2009 at 6:03 pm

I’ve read the book and all of the articles that I can find and I have questions: are you, I mean all these docs, saying that chronic pain can be cured by these treatments? By cured I mean stopping the constant pain and returning function.

If this is true and you are talking about treatments that cannot harm, why aren’t many, many pain doctors, orthopedists and neurologists prescribing these? I understand that drug companies would be against it but why haven’t we seem theses treatments adopted by many, many doctors.
I have always believed that when a cure or very effective treatment for RSD and/or chronic pain is found, it would spread throughout the medical and pain community very quickly. Theses studies have been goingon for 4 or 5 years and yet I do not know anyone who has tried them.Are people being cured and does the improvement continue? Are you seeing placebo type reactions? Are people looking better but then having increased levels of pain.

The theory makes sense and neatly ties everything into a packet but it also leaves the cure in the hands of patients. I do worry about what insurance companies can and will do with this theory to deny medicine and treatment besides these to people who are suffering.
This is very confusing for those who either give or seek treatment but want to stay away from anything invasive. Maybe we should all try these treatments and see what they could do for us. That is what I intend to do and hopefully, I’ll be reporting a cure or at least help in my battles with pain.
How to Cope with Pain // Feb 15, 2009 at 10:48 pm

Barbara, your points are very important. The short answer is a qualified ‘yes,’ they work. But it’s a “yes, but” or “yes, and.”

They work to decrease pain or eliminate pain – in some people, in some conditions. Some people are helped more than others, although we don’t yet understand why. Some people get permanent improvement, some need “booster” sessions.

I believe that the biggest reason why they aren’t more well-known and used more often is that these types of treatments fall outside of many doctors’ areas of expertise. It’s not what doctors like neurologists, anesthesiologists, rheumatologists, orthopedists do. It isn’t medication, it isn’t an injection, etc.

I believe that, while there has been some research, it hasn’t been a lot compared to, let’s say, medication. I’ve seen only approx 6-10 articles in major research journals in 5 years or so. And that was really because I thought these treatments were innovative and showed a lot of promise, so I followed up in reading more about them. You’re right that it’s really not well known at all.

I wouldn’t be worried about denial of care. (Unfortunately) nothing in pain medicine works for all, so this is one tool of many in your toolbox for relief and recovery.

It’s also not something that you do by yourself. I believe it’s best to have someone experienced in these treatments to guide your in using them.

Finally, I do believe that many more people could benefit from them. I hope that by reading about them here, people will ask their doctors, and seek out PT’s or others practitioners who use them. And organizations such as RSDSA are writing about them in newsletters and sponsoring conferences for practitioners to learn about them.

I hope you have success in trying this – let us know!
VICKIE // Feb 18, 2009 at 11:36 am

I TYPED UP A 7 PAGE INFORMATION PACKET ON R.S.D., OR COMPEX REGIONAL PAIN SYNDROME, WITH THYE HELP OF PRINTING OUT INFO FROM R.S.D.HOPE PAGE, AND I CARRY ONE WITH ME AND ALSO AM IN THE PROCESS OF GIVING THEM TO ALL CEO’S OF HOSPITALS. I AM SO SICK OF HEARING WHEN I HAVE TO CALL 911 OR USE MY LIFELINE, WHEN MY LEGS GIVE OUT, AND CANNOT SPEAK , ITS LIKE MY LEGS GO INTO CONVULTIONS. AND THEN THE AMBULANCE DRIVER SAYS, “YOU HAVE WHAT???” IT’S ABOUT TIME THIS DISEASE GETS KNOWN, TO ALL OF THE MEDICAL FIELD… PANHEADVIC
jeisea // Feb 19, 2009 at 2:22 am

HTCwP I hope you don’t mind my joining in this topic.

Barbara I can only speak for myself. I have had great results with brain retraining techniques which relieved pain and symptoms of Complex Regional Pain Syndrome and other pain. Early last year I believe I was in remission as symptoms had subsided, my autonomic responses were normal and I was only in minor pain. The pain I was experiencing was, I believe, unrelated to CRPS/RSD.

Unfortunately I had an accident which immediately returned pain and symptoms. However I’m using brain retraining methods to, I hope, eventually calm the autonomic nervous system again. HTCwP has many great posts about things that can be used to retrain the brain. Each “normal” movement reinforces the “O.K.” message. Guided imagery, meditation and controlled breathing, self hypnosis, mirror visual imagery, physical movement and touch, tactile discrimination (Moseley), acupuncture (laser is good) all help to retrain the brain. I use a variety of these methods and deal with one day at a time. Things happen to cause increased pain and flare up and it can seem as if I take one step forward and two steps back. However, with consistency and time I’ve improved and with more time, more noticeable improvement.

I’m very pleased to hear RSDSA is proactive in educating people to the benefits of these methods which as you point out are non drug and very cost effective. Mirror therapy has shown so much promise that NAAP Pharmaceuticals, a UK drug company, donated 2,500 mirror boxes to be distributed to pain clinics throughout the UK.