The treatment of chronic pain is a prime example of where high-tech, modern medicine has fallen short, disastrously short. Conventional medicine is focused on resolving symptoms in body parts when the real cause of most chronic pain isn’t the body, but in stress and trauma-induced circuitry in the brain.
The problem is that chronic pain is fueled by stress-induced brain pathways that don’t respond to treatment that’s mistakenly focused on the body. Effective treatment for chronic pain needs to focus on the brain’s emotional centers.
This helps to explain why in a medically advanced country like the United States, it’s estimated by the CDC that up to 20% of the population, or 50 million individuals, suffer from chronic pain.
It helps to understand that most physical injuries heal within three months, so lingering, chronic pain is a reflection of stress-induced imbalances in the brain and autonomic nervous system (ANS) rather than a lack of physical healing in the body. The focus is now on the brain.
Research Explains How Stress & Emotions Fuel Chronic Pain
You can learn more about the source of chronic pain in the Center for Disease Control (CDC) sponsored Adverse Childhood Experiences (ACE) study. The study concluded that childhood stress and trauma was a reliable predictor of adult illness, including chronic pain. The study confirms that our nervous systems will predictably translate emotional injury into physical disability, potentially decades down the line.
More research is validating the influence the brain and emotions have on our physical health. A 2013 study at Northwestern University showed that back pain of two months duration or less activated brain regions that are dedicated to acute pain and injury. However, when they looked at the brain activity of chronic back pain suffers of over ten years duration, the acute pain brain centers had become quiet, while emotional centers became active. This shows that acute pain and chronic pain are two very different biological experiences and therefore should be treated differently.
Another interesting study from 2015 (Brinjikji) assessed MRIs of three thousand pain free individuals. It revealed that structural abnormalities in the spine, like deteriorated or bulging discs, were very prevalent in this pain free population. This suggests that structural changes, that may be an expected and normal part of life and aging, for the most part do not cause pain.
A 2014 study (Steffens) that involved patients who did have chronic back pain, showed there was no connection between their pain and the abnormalities visible on MRIs.
A new study has focused on an inner or psychological approach to resolving chronic pain. The 2021 Boulder Back Pain Study involved fifty patients with chronic back pain. They were treated only with a psychologically based approach where two thirds of the participants reported being pain free or nearly pain free up to a year after the study.
Here’s another example of an emotionally focused intervention having a positive influence on chronic pain. A 2005 study (Broderick) demonstrated that emotionally expressive writing was effective in reducing fibromyalgia pain.
These studies are pointing the way toward highly effective, non-medical strategies for resolving chronic pain. The common element to these approaches is to focus on emotional experience in a new, mindful way that allows threatening emotions to actually be re-experienced as safe.
The experience of safety is the magic ingredient that transforms and defuses the fear based circuitry that fuels chronic conditions. Mindfulness, and particularly embodied mindfulness, is a time tested practice for learning to befriend and experience our emotions safely.
Dr. Sarno’s Pioneering Brilliance Healing Chronic Pain
John Sarno, MD, from New York University, discovered decades ago, before the above research was available, that most chronic neck and back pain responded poorly to conventional medical treatments like physical therapy, injections, and surgery. His research confirmed that most chronic pain was fueled by unconscious fears and could be treated much more effectively by consciously experiencing challenging feelings, sensations, and emotions.
He introduced patients to the practice of expressive writing as a simple, effective, and inexpensive therapy for chronic pain.
Dr. Sarno referred to this stress-induced pain as Tension Myositis Syndrome(TMS), or Mindbody Syndromes. Today, these mindbody conditions are called Psychophysiologic Disorders and the chronic pain aspect is referred to as neuroplastic pain.
Dr. Sarno was emphatic about patient education. He believed that a patient had to understand and believe that their chronic pain wasn’t a reflection of bodily damage and something to fear, but was a reflection of stress-induced brain circuity that can be resolved with the right kind of inner emotional processing. This is the most important step that allows an individual to stop worrying about their health and pouring more fuel on fear-related brain circuitry.
Embodied Mindfulness practice is an ideal self-help, therapeutic approach because it activates the brain circuitry responsible for experiencing safety while inhibiting the fear-based pain circuitry.
With our enhanced sense of interoception, or inner felt awareness, we’re able to become safely aware of and release the unconscious emotions that our systems have been defended against feeling. In this more relaxed, open state we’re able to let go of the stress and trauma-induced programming that fuels chronic pain and other chronic conditions.
From this new therapeutic perspective, chronic pain becomes a veiled invitation to become more emotionally aware and self-accepting. Awareness and self-acceptance, especially when felt deeply in the body, in your heart, is a viable and medically sound option for resolving chronic pain.
