Opinion Article - Journal of Nutrition and Human Health (2021) Volume 5, Issue 9
Where the Body Meets the Brain in Chronic Pain
Department of Pharmacology, Andhra University, West Godavari, Andhra Pradesh, India
- *Corresponding Author:
- Kommoju Geethanjali
Department of Pharmacology
Andhra University, West Godavari, Andhra Pradesh, India
Tel: + (970) 159-1905
E-mail: [email protected]
Accepted Date: September 26, 2021
Citation: Geethanjali K (2021) Where the body meets the brain in chronic pain. J. Nutr. Health Vol.5 No.9: 35.
Chronic musculoskeletal pain is one of the most difficult clinical issues for clinicians to solve, and it may be devastating for patients. Perceived pain that cannot be fully explained by somatic or neuropathic processes and is caused by physiologic changes in pain transmission or descending pain modulatory pathways is known as central pain amplification. Central pain amplification can exacerbate nociceptive or neuropathic pain in anyone. Patients with somatic symptom disorders may also experience changes in their psychological or behavioural responses to pain, which can have a substantial impact on their clinical presentation.
The genetic, physiologic, and psychological variables that contribute to central pain amplification are all being studied. Perceived stress and stress response systems are key contributors to chronic pain. The physiologic stress response and chronic pain symptoms have a complex relationship, as we and others have discovered. Unfortunately, chronic pain therapies are grossly insufficient and frequently worsen clinical results. It is critical to develop innovative therapeutic options for chronic pain patients. This paper lays forth a framework for thinking about chronic pain and coming up with new therapeutic options.
Body and brain: A historical perspective on chronic pain
There is a lot of information in the medical literature about the relationship between musculoskeletal pain and psychological discomfort, but just a few of them will be explored in this article. One place to start is with the description of "psychogenic rheumatism," where Nobel Laureate Philip S. Hench and Edward W. Boland describe the characteristics of US Army soldiers returning from war in 1946 in one of the early case series. Psychogenic rheumatism was one of the most common diagnoses, impacting about 20% of patients at specialised rheumatology clinics. “Psychogenic rheumatism — the musculoskeletal expression of functional problems, tension states, or psychoneurosis — is one of the most common causes of widespread or localised aches and pains in muscles and/or joints in civilian and military life,” according to their report.
Chronic pain genetic risk and environmental triggers
An individual's likelihood of acquiring central pain amplification may be predicted by a personal or family history of chronic pain, as well as anxiety and depression, due to shared genetic risk factors. Huge advances have been achieved in our understanding of pain genetics. Pain sensitivity is highly hereditary, as it varies across inbred mice and rats and runs in families in humans. In the typical population, pain sensitivity, or the reaction to acute psychophysical testing, follows a Bell-shaped curve. Pain sensitivity is linked to a number of genes, including ion channels and genes involved in the monoamine metabolic pathway, and there is some overlap between these genes and chronic pain problems. This could be due to the fact that pain and psychological responses to pain have several overlapping routes. Two key neurotransmitter pathways, for example, have been frequently linked to musculoskeletal pain.
Chronic pain, stress and arousal pain
Many researches have focused on stress and stress response systems in individuals with these syndromes since the development of centrally mediated chronic pain is connected with stressful events and symptoms often wax and wane depending on perceived stress. Our initial research focused on the Hypothalamic-Pituitary-Adrenal Axis (HPA) in chronic pain and tiredness, and we found changes in the system's dynamic function.
In chronic pain, self-regulation
It is commonly stated that chronic pain is accompanied by illness behaviors. The ability to self-regulate, or the ability to exert control over or guide and adjust reactions and behaviours, may be critical to successful adaptation to chronic pain situations.
Thoughts on chronic pain management
When 90 percent of a patient's discomfort is eliminated, the remaining 10% is 100 percent of what is left. This serves as a reminder that all pain is still pain. In addition, when pain becomes chronic, the goal is usually to manage it rather than to eliminate it. The intentional focus on eradicating pain — represented as pain as the fifth vital sign and pain alleviation being used to gauge the quality of a health care facility — is one of the most upsetting contemporary trends in medicine