Retrain the Brain to Deal with Chronic Pain

An interesting March 2019 article discusses a new way to help teenagers to deal with certain types of chronic pain. Pain specialists estimate there are thousands of young people suffering from inexplicable pain that intensifies, traveling randomly from one part of their body to the next. It primarily affects girls, though some boys also experience this type of pain.

Some doctors call it “amplified pain” and this term acts as a catch-all for a variety of diagnoses which are not yet well understood, particularly in children. For most of these children, the pain can’t be explained entirely by a current injury or infection. In some cases, pain seems to emerge after an injury, but it continues and increases long after the injury has healed. Doctors believe the pain comes from an overly sensitized nervous system.

The article follows fourteen-year-old Devyn, who suddenly experienced excruciating hip pain which eventually spread throughout her body, almost completely debilitating her. Pain medication did not help and she was told by many doctors that there was nothing wrong with her. One doctor finally suggested Devyn might have “amplified pain,” and this led Devyn’s mom to research a relatively new treatment that did indeed help her daughter immensely.

Basically, the treatment, which is often called intensive interdisciplinary pain treatment, puts the patient in even more pain to help them get better. Dr. David Sherry, a pediatric rheumatologist at Children’s Hospital of Philadelphia, believes the way we typically think about and approach pain is part of the problem. In his opinion our society concentrates too much on aggressively relieving pain. We know that the very act of paying attention to something reinforces connections in the brain, and the more attention paid, the bigger it becomes. Dr. Sherry’s hypothesis was that if you work with kids with amplified pain to push their bodies until they are in even greater pain, their brains, over time, will learn to ignore the pain.

Dr. Sherry published a study showing that 45 out of 49 patients had remained symptom-free for two years. The doctors interviewed in the article made it clear that more research is needed and this therapy is not for everyone with chronic pain.

When I read about intensive interdisciplinary pain treatment, I couldn’t help but compare it to exposure and response prevention (ERP) therapy , the evidence-based psychotherapy used to treat obsessive-compulsive disorder as well as some anxiety disorders. ERP is all about facing your fears. Intensive interdisciplinary pain treatment is all about facing your pain. The fears and the pain are both very real. With both therapies, you will habituate, or get used to, whatever fear or pain had previously debilitated you. Our brains are indeed trainable.

I make it all sound so easy, I know. I also know it’s not. ERP therapy and intensive interdisciplinary pain treatment are two incredibly difficult therapies. But they have a high success rate when people are committed to them. And perhaps most importantly, they both offer hope and a path to recovery for those who have likely been suffering a long time.

from World of Psychology https://psychcentral.com/blog/retrain-the-brain-to-deal-with-chronic-pain/