Understanding the complex mental experience of pain

Source: The Conversation

Not all people experience pain the same way. Some recover, but others have trouble recovering. Studies suggest that this isn’t because this latter group had worse injuries, or because of personality differences. Studies do suggest, however, that traditional treatments for chronic pain aren’t often successful.

This has lead researchers to question what, exactly, pain is. Is it merely a tissue issue? Or is it something more complex? What they do know is that pain is not just a matter of tissue damage, but an experience of mental processing as well.

The International Association for the Study of Pain defines pain as an experience. Danger receptors typically send messages from the tissues to the brain signaling pain. However, this process is “neither sufficient nor necessary for pain,” even if it is often associated with pain.

When the brain receives the message of pain, it must decide how serious the pain is, and this is based on a complex host of factors, including previous exposure and cultural influences. Pieces of knowledge stored in the brain called “neurotags” affect how people experience pain. They can actually lead to the negative thought of a condition (such as a slipped disc) to cause more pain than just the slipped disc itself would.

This process helps explain why pain is often a vicious cycle. The pain information presented by the neurotag “is actually being reinforced by itself.” Thus, treatment for chronic pain needs to consider how those negative thought cycles affect the experience and prolonging of pain.

This should also impact clinical approaches to teaching pain management, so that methods of care can be as nuanced and effective as possible.