In the last several posts, from a variety of angles, we’ve examined the mind-body dimensions of treatment for pain, seeing how it is essential to treat the trauma rather than the symptoms. This has involved treating the body as a carrier of meaning, whose history teach lessons which can be used to help patients’ re-conceive the metaphor of their injuries.

Just how though can patients train their brain and what should we know about this process?

Neurophysiology studies confirm that pain changes neuronal activity and anatomical connectivity in multiple areas of the brain, particularly in the areas of cognition and emotional assessment.

Acute tissue damage causing pain triggers changes in the central nervous system (CNS) that contribute to the development of secondary hyperalgesia and associated sensory disturbances. Yet within eight days, reversible CNS changes are measurable in healthy individuals who suffer from repetitive painful stimuli. This cortical reorganization, showing measurable CNS changes, has been linked to lower pain thresholds and hypersensitivity and may play a role in the development of chronic pain.

This reorganization of structural and functional connectivity in the neurons, or “plasticity”, is strongly activity-dependent. Negative psychological sequelae, such as fear avoidance and the symptoms of acute post-traumatic stress, are likely to impede functional recovery via these feedback pathways. In a recent study by Edgar, Dale et al., the authors proposed a cortical retraining program that could benefit burn patients by directing conscious attention to and normalizing sensation of the injured limb as pain-free. In the next post we’ll look more closely at the power of the brain to heal.