Chronic Pain May Be About Rewiring The Brain Instead Of Using Analgesics

12/10/2015 4:43 PM AEDT | Updated July 15, 2016 12:50
John Lund via Getty Images
Doctor putting human puzzle together

Chronic pain affects one in five Australians and costs the nation $34.3 billion annually, and new research suggests a solution could be in the way we think about it.

As Australia comes to grips with new research demonstrating a two-fold increase in death caused by codeine-based painkillers and demand for specialist pain clinics mean waitlists stretch two years, Australia's best minds are meeting to call for an endorsed national pain strategy.

Director of the ARC Centre of Excellence for Nanoscale BioPhotonics Mark Hutchinson said chronic pain was not simply an injured part of the body.

"People say ‘please doc, give me an opioid to switch off my pain' but that’s not the case," Hutchinson said.

"We now know that absolutely in acute pain, there's some form of injury -- some form of danger signal -- and we can modify pain processing within the central nervous system to some extent using a drug like a morphine."

chronic pain

Painkillers only provide temporary relief of pain. Picture: Vetta via Getty Images

"But when it switches over to chronic pain, that’s when it becomes really difficult," Hutchinson added.

"It's an entirely different situation."

Hutchinson said people with chronic pain didn't necessarily have an ongoing injury but their brain was continuing to create pain signals.

"This danger signal that's generated in the central nervous system is beyond our eyes -- we don't have tools yet to be able to measure it but they are truly experiencing and expressing long-felt pain.

"We've had to rethink pain and Australia has been at the forefront."

Hutchinson said the challenge was to work with a patient to "change that person's brain so that they are able to feel pain differently".

Enter University of South Australia Chair in Physiotherapy Lorimer Moseley, who is working on changing the way people feel about chronic pain.

"Our group has been targeting what people think their pain means," Moseley said.

"The old, dangerous meaning of chronic pain is it means chronic and worsening damage and this meaning is supported by our whole system. Our language -- 'I've got a ruptured disc', 'a herniated disk', 'your back is out' -- these are all metaphors that are catastrophic and totally inaccurate.

"The same thing happens at your ankles and you call it a strain or a sprain."

Moseley said that when someone told their GP they had chronic pain, he'd like them to be told recovery was a journey.

"There is a journey in front of people," Moseley said.

"There's no quick fix for chronic pain but there is a rehab journey and we know that people's lives improve and ultimately their pain and disability reduces but they need coaches they don't need the next short-lived pain relief."

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