Pain relies on many brain pathways, not just one – new findings could change treatment of chronic pain and fibromyalgia
We know that mindset can affect our experience of pain; for example, an athlete may report that while competing an injury did not feel especially painful in the heat of the moment. And now scientists reveal why in research published in PLOS Biology, paving the way for a new approach to tackling fibromyalgia and chronic pain.
The experts involved found that when we use our thoughts to dull or enhance our experience of pain, the physical pain signal in the brain does not actually change. But the act of using thoughts to modulate pain, a technique called cognitive self-regulation that people often use to manage chronic pain, works via a separate pathway in the brain.
Volunteers were given painful heat stimuli on their arms while their brains were scanned using functional magnetic resonance imaging.
For the first scan, the volunteers were asked to experience the painful heat without thinking of anything in particular. In another scan, they were asked to imagine that the sizzling hot heat was actually damaging their skin, a thought that increased their experience of the pain. In a third scan they were asked to imagine that the heat was actually a welcome sensation on an extremely cold day, a thought that decreased their experience of the pain.
When the scans of the brain were compared the experts saw that the signal for physical pain was the same in all three scans, regardless of how the volunteers rated their pain experience. But a signal in the brain using a second pathway changed in intensity depending on the type of thoughts, or “cognitive self-regulation” used.
“We found that there are two different pathways in our brains that contribute to the pain experience,” said Choong-Wan Woo, lead author of the study.
The first pathway includes a number of “classic” regions in the brain, such as the anterior cingulate cortex.
The second pathway, discovered in the study, mediates the effects of cognitive regulation, and involves increasing activity in brain regions that are involved in emotion and motivation but do not typically respond to painful events in the body. This pathway may hold some of the keys to understanding the emotional aspects of pain, which can contribute s to long-term pain and disability.
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Image credit: Birth into Being
