Pain on the brainPain on the brain
All In The Mind
Do you, or does someone you know, live with chronic pain? At least 1 in 5 Australians do, and very often the cause of their pain is not evident—it makes treatment particularly challenging. Scientists are now realising that the brain plays a crucial role in how pain is experienced, and it’s opening the way for some innovative treatments.
31:27•13 Mar 2016
Pain, Perception and the Brain: Why Chronic Pain Won’t Let Go
Episode Overview
- Pain intensity doesn’t necessarily match the amount of tissue damage, especially in chronic conditions.
- The brain modulates a metaphorical “danger gate” in the spinal cord, increasing or decreasing pain based on perceived threat or safety.
- Subtle changes in the thalamus and prefrontal cortex, including reduced GABA, can keep danger signals and difficult emotions constantly amplified.
- Targeting body perception with visual and sensory illusions can alter feelings of pain and stiffness without changing actual joint mechanics.
- Partners’ responses to pain expressions strongly influence disability and coping, and shifting towards broader emotional support can improve quality of life.
“Any evidence that your tissue is in danger will increase your likelihood of pain and the intensity of your pain. Any credible evidence that your tissue is safe will decrease it.”
Ever wondered why a tiny paper cut can hurt more than a serious bruise you don’t remember getting? This episode of All In The Mind looks at what that odd mismatch says about pain and the brain. Host Lynne Malcolm chats with pain researchers and clinicians who show that chronic pain is far more than a simple signal from injured tissue.
Professor Lorimer Moseley explains how a “danger gate” in the spinal cord is influenced by the brain’s judgement about how much protection you need: “The brain is ultimately the big kahuna in making the decision about what’s biologically advantageous for you as an organism.” Even colours can change pain; a cold stimulus paired with a red light is reported as hotter and more painful than the same stimulus with a blue light.
Dr Sylvia Gustin takes you inside the thalamus and prefrontal cortex, where subtle changes in volume and the neurotransmitter GABA can keep the brain’s border for danger messages permanently open. Her patients live with ongoing pain long after injuries have healed, and many struggle with anxiety, depression and stigma. By using neurofeedback and mindfulness, her team helps people shift their brain state and rewrite painful memories. Dr Tasha Stanton focuses on how people in pain perceive their own bodies.
People with osteoarthritis often see their painful hand or knee as smaller than it really is, and feel stiffness that doesn’t match how the spine actually moves. Through clever visual illusions and sound pairings, she shows that changing what the brain sees and hears can change what the body feels. Clinical psychologist Toby Newton-John brings in the social side, showing how partners’ reactions can unintentionally increase disability or, with thoughtful emotional support, help pain feel less overwhelming.
If pain is so closely tied to the brain, perception and relationships, what new possibilities does that open for people living with it every day?
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