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Pain and the brain: How love, fear, and much more affect the experience of pain


The old maxim “pain is just a feeling” is more true than we thought.

In his address for last fall's Stanford Back Pain Education Day, Sean Mackey, MD, PhD, chief of the division of pain medicine, provided insight on the many factors that affect experience of pain. “Pain is an incredibly subjective experience,” he said.

This subjectivity is reflected by the wide variability of responses to the same pain stimulus. “We all conduct that information from our bodies much the same way, but it’s not until it gets to our higher brain centers that our individual differences get shaped by all those little amplifiers,” like genes, personality, and temperament, Mackey explained. This has implications not only for a person’s likelihood of developing chronic pain, but also means there's not likely to be a “one-size-fits-all” treatment for pain.

“The pain that you have fundamentally alters your brain structure,” Mackey said. But there are ways to improve your experience of pain, he said, adding that fear of pain increases one's susceptibility to pain, while experiencing love builds resilience to pain. “As a physician, I can't write you a prescription for a passionate love affair every year. That won't fly, not even in Vegas. But I can tell you to go do something rewarding. Go do something fun."

And his advice for those suffering from pain?

“It’s not just about the body. And it’s not just about the brain… It’s about everything. It’s all interconnected,” Mackey said. “Target everything — and take back your life.”

Previously: Is pain in the brain? A pain psychologist discusses alternative to opioids, Yes, chronic pain and joy can coexist and Chronic pain: Getting your head around it

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