A 29-year-old construction worker in London accidentally jumped onto a 15-cm nail that pierced through his shoe. He was in extreme pain.
The man was rushed to the emergency room and sedated with pain medication. However, when the doctors pulled out the nail and took off the man's shoe, they discovered that his foot was completely untouched. The nail had neatly slid between his toes without penetrating his foot.
Published in the British Medical Journal in 1995, this famous medical case highlights how pain can be neuroplastic, meaning the brain can trigger pain signals without any physical injury.
The construction worker's brain generated pain when it perceived danger and stopped generating pain when it perceived no danger, said Yoni Ashar, a clinical psychologist and assistant professor of internal medicine at the University of Colorado Anschutz Medical Campus.
"All pain is brain-generated, and regardless of whether or not that pain is associated with a true injury, that pain is real," Ashar told The Epoch Times.
The brain is a unique organ because of its plasticity, or ability to change and make new neural connections. Plasticity allows us to learn new skills and languages or recover from brain injuries like strokes. However, neuroplasticity also means the brain can learn things like pain, according to Ashar.
Stress, depression, or anxiety can put the brain on high alert or in fight-or-flight mode, he said.
The brain that is stuck in the high-alert mode causes a release of stress hormones into the bloodstream. Such a hypervigilant brain can erroneously send danger signals even when no real threat is present. Over time, these incorrect signals may become hardwired into our nervous system, leading to chronic pain.
"The good news is that we can harness that same plasticity to help your brain unlearn your pain," Ashar said.
According to Centurion, this happens when people avoid emotional stressors that the conscious mind doesn't want to process. At a subconscious level, that emotional distress becomes physically expressed in the body. Back pain is just one common area where this tends to manifest, enabling the brain to focus on physical pain rather than emotional discomfort, he said.
Based on neuroscience research on chronic pain, "there is a slow but growing recognition among the medical community that chronic back pain is influenced by the brain's pain processing system, stress, and emotions," he said.
Besides pain relievers such as steroidal and non-steroidal anti-inflammatory drugs and opioids, which are used to manage chronic pain, studies have shown that several mind-body-centered psychological options, such as pain reprocessing therapy (PRT), meditation, and qi-gong (exercises to move energy) can effectively relieve chronic back pain by calming the nervous system and rewiring the brain's pain pathways.
The late physician John E. Sarno, one of the pioneers of mind-body medicine, referred to emotion-triggered pain disorders as Tension Myositis Syndrome (TMS), also known as the mind-body syndrome. Several well-known individuals, including Jimmy Kimmel, Howard Stern, Larry David, and Anne Bancroft, have publicly credited Sarno with curing their back pain after reading his books.
Centurion, a neurologist with more than 20 years of experience, recalls one of his patients with chronic lower back pain who found relief using Sarno's method. The patient was struggling with chronic pain and had tried physical therapy and a variety of methods without significant relief.
The daily reminders and the pain-emotion connection helped the patient realize that he'd been harboring years of anger and resentment toward his mother over a family issue. He believed his mother had treated him unfairly when distributing the family inheritance. As the man began to let go of his hard feelings, his chronic pain gradually disappeared.
Charli began journaling following the mind-body technique. Even before she realized it, writing in her journal helped her release emotions from her childhood to adulthood that may have been building up tension and contributing to her stress. At first, she felt writing about things that annoyed her was pointless. But, she said, emotions often come out while journaling that one doesn't even think about. It helped her process difficult emotions, and she began to feel her pain fading away.
Now, whenever she experiences new physical symptoms, she first looks inside, reminding herself to see how she is feeling at the moment. She considers painful sensations a message from her body asking her to "tune into something" she might have been ignoring. She said that the human body is so much more powerful than we think, and we have the tools within us to help ourselves.
Somatic tracking is a core PRT technique that encourages patients to observe their pain with curiosity and reconceptualize it as physical sensations that are not harmful. They are guided to participate in routine activities, such as walking or bending, which they may have been avoiding due to fear of pain, and reappraise painful sensations as safe by reframing their pain beliefs. Finally, PRT addresses the emotional element of pain -- patients are guided to recognize and process their stress, anxiety, and past trauma and cultivate positive feelings.
PRT helps patients break the pain-fear cycle and rewire the brain's neural connections.
The results showed that 66 percent of patients in the PRT group became pain-free or nearly pain-free at the end of four weeks of treatment, compared to 20 percent in the placebo group and only 10 percent in the usual care group that had continued their ongoing care without receiving any other treatment during the trial. The health gains were largely maintained through one-year follow-up.
Following the completion of PRT, participants were interviewed about their experiences. They described the pain-emotion connection as a crucial treatment component and that PRT helped them distinguish between two types of pain: pain caused by injury and pain resulting from emotional discomfort. They showed a shift in mindset regarding their perception of pain.
Ashar believes non-pharmacological approaches like pain reprocessing therapy and related treatments could have a huge effect on this intractable problem in health care, offering "a promising path forward -- one where recovery from chronic pain is possible."