Chronic Pain: The Science of Unlearning Pain
The article explains that chronic pain can persist even after an injury has healed, as the brain continues to send pain signals due to altered neural pathways. It highlights that treatments are shifting from purely physical approaches to include pain education, cognitive behavioral therapy, and techniques that help patients "unlearn" pain by retraining the brain's perception.
Background
- Chronic pain is pain lasting months or years beyond normal healing, affecting ~1 in 5 adults in the West. Unlike acute pain, it can become a "learned" condition where pain circuits stay overactive even after the original injury heals.
- The article covers **pain reprocessing therapy (PRT)**: training the brain to stop mislabeling safe bodily signals as dangerous. This reflects a shift from purely structural explanations (e.g., "your scan shows a disc bulge") toward understanding the nervous system's role.
- Key figures: **Dr. John Sarno** (NYU, 1970s–2000s) — argued repressed emotions cause chronic pain, long dismissed but later validated. **Dr. Alan Gordon** — developed the structured PRT approach. **Dr. Lorimer Moseley** (Australia) — pioneered "explain pain" education.
- Clinical terms: **central sensitization** — the CNS stuck in high-alert mode, amplifying normal signals into pain.
- Why it matters: PRT is gaining traction and insurance coverage in the US/UK but remains controversial among surgeons and interventional pain doctors whose practices rely on injections and operations.