Before discussing the role of Neuroplasticity in chronic pain management it is important to have a working definition of the term.  Neuroplasticity (variously referred to as brain plasticity or cortical plasticity or cortical re-mapping) refers to the changes that occur in the organization of the brain as a result of experience. A surprising consequence of neuroplasticity is that the brain activity associated with a given function can move to a different location as a consequence of normal experience or brain damage/recovery.

It is now indicated that this capacity for rewiring of the neuronal synapses to allow for re-development of entire regions of the brain is present in adults as well as children.  Newly discovered principles of adult neuroplasticity are at the heart of some of the most revolutionary and groundbreaking brain research. 

Pain research presented by the American Society of Anesthesiologists has emphasized the molecular transduction of painful stimuli, the sensitization processes that occur after injury and long-term phenomena such as pain memory.  Neuroplasticity after surgery occurs at the transduction process, in the periphery at the sub-cellular level, or in the central nervous system, where central sensitization occurs.

According to Kenneth Sufka in his article published in Brain and Mind Journal:

Pain that persist long after damaged tissue has recovered remain a perplexing phenomenon.  This so-called chronic pain serves no useful function for an organism and, given its disabling effects, might even be considered maladaptive. However, a remarkable similarity exists between the neural bases that underlie the hallmark symptoms of chronic pain and those that serve learning and memory.  Both phenomena, wind-up in the pain literature and long-term potentiation (LTP) in the learning and memory literature, are forms of neuroplasticity in which increased neural activity leads to a long lasting increase in the excitability of neurons through structural modifications at pre- and post-synaptic sites.

According to researched published in Pain Physician Journal (2006), 90 percent of people in the US receiving treatment for pain management are prescribed opiate medication.  Of that number 9 percent to 41 percent had opiate abuse/addiction problems.  According to research published in Annals of the New York Academy of Sciences 933:175-184 (2001) titled “Spinal Cord Neuroplasticity following Repeated Opioid Exposure and Its Relation to Pathological Pain;” convincing evidence has accumulated that indicates there are neuroplastic changes within the spinal cord in response to repeated exposure to opioids.  Such neuroplastic changes occur at both cellular and intracellular levels.  Since so many people living with chronic pain are using opiates these neuroplastic changes need to be better understood.

To learn about developing a more effective chronic pain management plan, please check out my article 12 Personal Actions Steps for Chronic Pain and Medication Management that you can download for free on our Article page.

If you’d like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I’m very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this and my other upcoming trainings you can check out our Calendar page.

You can learn about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Hypnosis has been an effective tool for many medical conditions including chronic pain management.  However, there is still significant mistaken beliefs about this procedure and it sometimes evokes memories of movie’s that portray hypnosis as entertainment and deception.  The fact is that hypnosis has become well respected in the medical field and the American Society of Clinical Hypnosis (ASCH) celebrated their 50th anniversary last year.

One of their members, Dr. Mark B Weisberg, put together a report titled Fifty Years of Hypnosis in Medicine and Clinical Health Psychology: a Synthesis of Cultural Crosscurrents.  I’m going to reproduce the conclusion of that report below. 

The developments of the last 50 years have profoundly influenced the practice of hypnosis today. In response to the progress in the field, our assumptions about what can be accomplished clinically have also changed, as have our understanding of the mechanisms responsible for the changes we seek on behalf of our patients. A substantial body of research demonstrates the efficacy of hypnosis as part of the integrative treatment of many conditions that traditional medicine has found difficult to treat. For some disorders (such as irritable bowel syndrome) the evidence for the efficacy of hypnosis is so robust that it could be argued that it is unethical not to inform patients about this treatment modality.

Better evidence exists now supporting the use of hypnosis to relieve discomfort associated with many diagnostic and invasive procedures. The emergence of the PNI literature informs us that modalities such as hypnosis may not only enhance comfort, but may also alter physiological parameters in many conditions. The advent of increasingly sophisticated brain scanning technology has revealed new insights about how various types of hypnotic suggestion changes the activity of specific brain structures. The progression from alternative to integrative medicine cautions us to be open to new therapeutic developments, but not without good empirical support. The debate over hypnosis and possible memory distortion reminds us to remember the fallibility of memory, but also not to throw out the baby with the bathwater.

What’s in store for the next 50 years? What will the retrospective on healthcare reveal in 2058? Most well publicized predictions focus on anticipated advances in technology. Improved genetic screening and treatments of everything from cancer to heart disease will be available. Pill cameras will become more commonplace, replacing x-rays and implants. Implanted monitors and drug dispensers are predicted to normalize the lives of diabetics. Physicians will increasingly use telemedicine to make house calls. Our pharmacopoeia will become increasingly customized, aided by new genetic discoveries.

I also predict that the next half century will bring a more comprehensive understanding of the neurobiological mechanisms that allow us to heal naturally. The newest, most advanced technology will increasingly confirm the efficacy of centuries-old health practices. These developments will enhance our capacity to catalyze patients’ untapped potential for selfhealing. Hypnosis speaks profoundly to every level of our psychophysiological functioning. Applications of hypnosis in healthcare will continue to expand as the emerging science proves its efficacy in greater detail.

To learn about obstacles in chronic pain management please check out my article Overcoming Obstacles for Effective Chronic Pain Management that you can download for free on our Article page.

If you’d like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I’m very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this 3 day 20 hour training and my other upcoming trainings you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you or a loved one is undergoing chronic pain management, especially if you’re in recovery or believe you may have a medication or other mental health problem and you want to learn more effective chronic pain management tools, please go to our Publications page and check out my books; especially the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Most people will readily agree that regular exercise is good for you, and when combined with a healthy diet will help people gain or lose weight, and generally improve their quality of life.  Unfortunately, many people with a chronic pain condition mistakenly believe that they can no longer get the full benefits of exercise.  Dr. Egoscue in his book, Pain Free: A Revolutionary Method for Stopping Chronic Pain, is very adamant that flexibility and mobility are the keys to successful chronic pain management.

I discovered a study highlighting the benefit of even modest exercise titled Modest Exercise Helps Chronic Pain Patients that was presented on February 15, 2008 at the American Academy of Pain Medicine 24th Annual Meeting.  Please see an excerpt below.

The review aimed to determine the effect of a 3-week aerobic training program on physical conditioning and to assess the acute effects of a brief, 10-minute exercise protocol on pain, mood, and perceived exertion. The final sample of 28 patients — lowered from 54 due to factors such as lack of motivation to exercise and fear of exercise — had an immediate perception change about exercise upon starting the program.

Measures of heart rate, mood, pain, and perceived exertion were obtained. On average, patients received 5 hours of conditioning per week, in addition to routine daily activities. Results demonstrated significant short- and long-term benefits of exercise. Patients showed a statistically significant reduction in exercise-induced cardiac acceleration from admission to 3 weeks. The brief exercise protocol also produced significant immediate antidepressant and anxiolytic effects. The research suggests that relatively modest exercise leads to improved mood and physical capacity, which has further implications for mortality risk. The review also suggests that brief exercise is a safe, cost-free, nonpharmacological strategy for immediately reducing depression and anxiety [which often accompany living with chronic pain].

I believe that exercise can and should be part of all pain management plans.  The type and frequency of exercise is the important factor which requires someone with experience and clinical skills to develop an effective—and safe—program.  Rest and immobilization periods (or up-time and down-time), should also be an integral foundation of the plan. 

Other important considerations include the style of exercise, the progression of intensity, the frequency or quantity, and the prevention of additional injury.  As mentioned earlier, hydrotherapy and water exercises can be very beneficial for people with chronic pain issues.

To learn about using a best-practice and research-based chronic pain management treatment protocol please check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Article page.

If you’d like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I’m very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this and my other upcoming trainings you can check out our Calendar page.