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Acute pain is your body’s way of warning you about an injury
that needs to be taken care of. With chronic pain, pain persists long after the injury has healed.
Pain signals keep firing in the nervous system for weeks, months, even years.
Chronic
pain can follow and actual injury that has healed, such as a sprained back or serious infection, or there can be an ongoing
cause of pain, such as arthritis or cancer, and someone can also experience chronic pain without any past injury or ongoing
illness. The experience of pain involves multiple and
interactive neural pathways that influence pain signals at several levels at once: the sensory organs, the spinal cord, and
the brain at both the cortical and subcortical levels. Pain pathways become
stimulated by painful stimuli and, with repeated stimulation, these pathways can become altered and start firing independently
of a painful stimulus. With repeated exposure to certain stimuli, a person becomes more sensitive to the
stimuli and responds with greater and longer lasting pain. These changes in the brain, in turn, affect
the endocrine and immune systems of the body. Through these multiple and interacting pathways, pain becomes
amplified, it triggers more neural networks, and it becomes self-sustaining and resistant to treatment. These
events result in disturbances of mood, sleep, energy, libido, memory/concentration, behavior and stress tolerance.
The neural pathways that are involved in pain sensation overlap the pathways
involved in depression. So pain not only stimulates sensory areas of the brain, but activates emotional
centers as well, resulting in depression, anxiety and fear. In addition, depression activates brain centers
involved in pain sensation.
Evidence shows that the experience
of pain is linked to EEG, or brain wave, activityTeaching patients to alter EEG activity to reflect
activity that has been shown to be associated with reduced pain may be promising. More intense pain sensation
has been associated with a decrease in alpha activity and an increase in beta activity. Acute pain relief
has been associated with decreases in beta and increases in alpha activity. Decreasing some types of medically-related
pain has also been associated with rewarding SMR activity, a special frequency of low beta activity, and inhibiting theta
activity.
Research applying neurofeedback to the treatment of
pain has included multiple chronic pain conditions, including chronic back pain, peripheral nerve injury, pain from cancer,
fibromyalgia, trigeminal neuralgia, migraine headaches and complex regional pain syndrome. In this practice,
we have also treated chronic gastrointestinal pain and chronic testicular pain. We
tailor the treatment to each patient’s unique situation and responses to the training. The training
usually involves enhancing alpha and SMR activity and inhibiting theta and beta activity in different regions of the cortex
through neurofeedback training.
Much of the evidence for the
use of neurofeedback to treat chronic pain can be found in the following journal article: Jensen, MP, Sherlin, LH, Hakimian, S & Fregni, F (2009). Neuromodulatory approaches for chronic
pain management. Journal of Neurotherapy, 13, 4 pp. 196-213.
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