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Rewiring the Chronic Pain Brain

Pain can be unlearned. It is meant to serve a crucial but temporary role in our lives: to alert us of danger and to influence appropriate action. This is certainly the case when we place our hand on a hot stove: pain signals immediately shoot to our brain and initiate a muscle reflex to remove our hand from the flame before we even become conscious of the source of pain itself. This mechanism evolved to optimize our chances for survival.

In the case of chronic pain which cannot be explained though, there is no such adaptive advantage. Instead, chronic pain exists in large part because our brains (specifically our “sensory cortex”) have been rewired to perceive danger even when it ceases to exist. To take that idea a step further, the area where we would feel “hand pain” actually grows in size at the expense of other crucial neurological functions. This concept is well aligned with the relatively novel idea of neuroplasticity: new connections can be made as our brain has new experiences and processes new data. While this can be beneficial in the recovery of function after traumatic brain injury or stroke, it can have a negative impact as well: we can program ourselves to experience a continual cycle of discomfort with no known cause.

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