Health

The Connection Between Chronic Pain and Emotional Pain

By Nicolas Rivera

February 15, 2020

Pain is a term used to describe a physical affliction or discomfort that may be caused by an injury or an illness. Two things we discover when we look at the definition of pain. For starters, we realize pain is a feeling—an emotional phenomenon. Also, we realise that pain is not pleasant. That’s why people often feel agitated when they are experiencing pain. However, most people only think of pain as a physical problem because when pain occurs, all we can think about is trying to find ways to stop feeling the discomfort.  But pain is more than just a physical manifestation; it’s just as much an emotional issue as it is a physical one. The emotional component of pain is intensified during childhood. It may feel awful to skin our knee, but mommy’s (or dad’s) hugs, kisses and a Band-Aid makes all the pain seem to go away. However, when we become adults, we disconnect from the emotional aspect of pain. Unfortunately, the only way to treat chronic pain successfully is to deal with the emotional aspect of it.

For starters, let’s look at how pain affects the brain. Functional MRI research reveals that the same areas in the brain impacted by emotional discomforts are the same areas affected when people experience pain.  In the brain, the signal for pain travels from the sensory cortex—the part of the brain responsible for sensory input—to the limbic system—the area of the brain responsible for processing emotions. In laymen’s terms, chronic pain shifts from being physical to emotional. Also, the limbic system is an important part of the brain involved in addiction.

Past Trauma and Chronic Pain

A lot of people experiencing chronic pain have had some sort of traumatic event in their life. It does not necessarily mean they’ve experienced physical,  verbal or emotional abuse because some people develop trauma from severe emotional experiences like grief or loss. If the trauma has not been addressed, it can often resurface as chronic pain.

It’s impossible to treat pain if we don’t deal with the origin of the pain. The western world’s take on pain leads people to search for a physical culprit such as a disease, a condition like arthritis, body misalignment, tumours, etc. Although these are good places start, we cannot ignore the possibility of emotional factors being involved such as child abuse, sexual abuse, substance abuse, mistreatment or some other issue causing emotional pain. We also need to consider how physical injury (especially an injury that has impaired mobility) and disease impact our emotions when undergoing pain.

Pain specialists that are not doctors (i.e., yoga instructors, acupuncturists,  massage and reiki therapists) are good at discovering the origins of people’s pain because they address the whole person instead of focusing on one area. So, these practitioners are also great options for finding a solution to handling chronic pain.

Pain management is successful when practitioners employ a multidisciplinary method for addressing the pain. When people seek help from us, they’ve already exhausted their list of remedies to alleviate the pain.  Unfortunately, when people get to us, they’ve already had a negative encounter with doctors who dismissed their pain as imaginary or treated their pain as if it was not a big deal. However, we understand their pain and know their pain is not in their mind. That’s why we take a multidisciplinary approach to make sure we address all areas associated with the pain so the patient is provided a successful treatment option.

Treating the Emotional Aspect of Chronic Pain

Addressing chronic pain is our priority because chronic pain can often lead to substance use disorder or relapse in recovering addicts. We also help patients with chronic pain withdraw from medication regardless if they are misusing it because people who experience chronic pain tend to use medications as a solution for handling the physical and emotional aspects of their pain.

Here are some nonmedical strategies used to address the emotional aspect of pain:

Focus on life stressors. Stress intensifies pain. So, an effective approach to alleviating pain is recognising and eliminating stressors. By addressing life stressors, people are indirectly changing the brain pathways that react to their pain.

Emotional awareness is key.  Scientific research on pain reveals that people who stifle their emotions don’t handle pain well.  Therefore, it’s important people learn how to get in touch with their emotions. For example, journaling and mindfulness are techniques often used to help people recognize the emotions that accompany their pain.

Overcome the fear of pain. People often have an exaggerated perception of the pain they are experiencing.  So, they began to feel helpless, which means the person may not be willing to move around as much. They start saying things like, “If I try to do too much around here, it’ll just cause even more pain.” In other words, fear of pain makes people feel there is no hope of getting better. However, once people understand that there are ways to deal with the pain that don’t require medication, they will stop thinking there’s no escape from their pain.

Family communication skills help. It’s important to include family members when treating chronic pain. So, learning how to communicate our feelings to our family members (or caregivers)  helps us develop effective ways to express when we’re in pain. When people are in chronic pain, everyone around them suffers—just like people do when addiction is involved.

Keep it moving. Research has proven that movement often helps alleviate pain because it helps eliminate stress and elevates a person’s mood. Strategies like acupuncture, yoga, hydrotherapy, mind-body therapies, physical therapy and massage therapy are often used to treat chronic pain.

All pain is real Medical studies have proven a definite relationship between chronic and emotional pain.  When it’s hard for people to get a diagnosis for their pain, they are often told that the pain is all in their mind or a part of their imagination.   And it is in their mind, but they are not imagining the pain. The pain is very real because of the close relationship between the body and the mind. So, now we need to ask, “What’s the origin of this pain, and how do we address it?

The world of medicine is still in its infancy concerning how to address chronic pain related to emotional pain because many researchers in the field have yet to grasp an understanding of the multi-faceted and biopsychosocial aspect of pain. They need to understand the multi-dimensional, biopsychosocial nature of pain. Patients suffering from chronic pain recover when doctors empathise with them and take their case seriously.  Good doctors will go the distance to discover the source of the pain instead of offering a quick-fix prescription (which may do little to solve the problem).

Good doctors know the right time to refer patients to addiction specialists when they have been on opioids for a long time. Also, good doctors will know whether their patient will benefit best from a comprehensive pain program or an interventional pain specialist.  Hopefully, more doctors will challenge insurance companies to start covering more alternative programs. Proper care when addressing chronic pain saves time and money for both the patient and insurance companies.