Effect of environment on the long-term consequences of chronic pain

Abstract

Much evidence from pain patients and animal models shows that chronic pain does not exist in a vacuum, but has varied co-morbidities and far-reaching consequences. Patients with long-term pain often develop anxiety and depression and can manifest changes in cognitive functioning, particularly with working memory. Longitudinal studies in rodent models also show the development of anxiety-like behavior and cognitive changes weeks to months after an injury causing long-term pain. Brain imaging studies in pain patients and rodent models find that chronic pain is associated with anatomical and functional alterations in the brain. Nevertheless, studies in humans reveal that life-style choices, such as the practice of meditation or yoga, can reduce pain perception and have the opposite effect on the brain as does chronic pain. In rodent models, studies show that physical activity and a socially enriched environment reduce pain behavior and normalize brain function. Together, these studies suggest that the burden of chronic pain can be reduced by non-pharmacological interventions.

Allostatic load and pain severity in older adults: Results from the English Longitudinal Study of Ageing

“…We extend previous findings by applying a similar definition of pain severity in a large population-based study of older adults and demonstrate that adults with greater pain severity also show a greater biological burden as indicated by a greater allostatic load. As such, our findings align with pain-related neurobiological changes reported [5, 30, 31] and extend previous findings by demonstrating the importance of considering pain severity, specifically frequency and intensity, when evaluating the biological interface of pain and associated biological, behavioural, and psychosocial stressors.…”

Anatomy and Pathophysiology of Chronic Pain and the Impact of Hypnotherapy

“…The influence of reduced gray matter density is further demonstrated in studies that have examined decreased level of concentration and attention capabilities of chronic pain patients (Bushnell et al, 2015).…”

“…In fact, reduction in gray matter exacerbates and extends pain sensation (Apkaria, 2004;Geha et al, 2008, Bushnell et al, 2015. Moreover, it is suggested that the experience of ongoing pain further reduces gray matter density (Bushnell et al, 2015). Reduced gray matter in the cingulate and frontal cortices have shown varying degrees of cognitive dysfunction amongst chronic pain patients (Luerding et al, 2008).…”

“…These changes directly reflect the level of anxiety and depression experienced by chronic pain sufferers (Bushnell et al, 2015). In fact, reduction in gray matter exacerbates and extends pain sensation (Apkaria, 2004;Geha et al, 2008, Bushnell et al, 2015.…”

Yoga: Can It Be Integrated with Treatment of Neuropathic Pain

“…A large body of evidence from the patients suffering with pain as well as associated animal models has revealed that chronic pain is not unifactorial but has many comorbidities and consequently may lead to anxiety, depression, and cognitive decline [25][26][27][28][29][30] .…”