VRx by Brennan Spiegel

Author:Brennan Spiegel [SPIEGEL, BRENNAN]
Language: eng
Format: epub
Publisher: Basic Books
Published: 2020-10-06T00:00:00+00:00

Acute pain is an appropriate and time-limited response to tissue damage. If you get stuck with a pin or put your hand near a hot stove top, then your pain nerves fire, the signals pass up the spinal cord, and your brain registers the “ouch.” This continues until the damage heals and the nerves stop firing. Then the pain goes away and you return to normal.

But chronic pain is different. In some cases, like with Robert Jester, the tissue injury takes time to heal and the pain signals continue to bombard the spinal cord and brain. Over time, this nonstop stimulation leads to pain sensitization, where the nervous system exaggerates pain signals beyond what is appropriate for the amount of physical injury.12 It’s as though the body accepts a new mission to warn the brain of imminent danger despite there being little or no threat. In the spinal cord the pain signals are amplified and shot up to the brain with greater frequency, intensity, and duration than would otherwise normally occur. The unabated pain signals inundate the brain, causing anxiety, depression, and mental distress. The brain loses control of its defenses and no longer blocks the pain effectively. The result can be a vicious cycle of worsening pain even after the original injury is long gone.

These changes can become semipermanent if they are not stopped. Our central nervous system is “plastic”: its structure and function can change over time, for better or for worse. As the spinal cord and brain continue to withstand a salvo of pain signals, the nerves begin to rewire themselves. The pain gates in the spinal cord swing open and stay open. The nerves keep firing, even without a persistent injury. The result is unflagging pain, anxiety, depression, sleeplessness, exhaustion, irritability, and worst of all, diminished ability to do anything about it. People become helpless and hopeless. The psychic pain can be more overwhelming than the physical pain. Anyone who has felt this kind of pain knows the depths of suffering a human can sustain.

Ronald Melzack, co-originator of the gate control theory, offered this stark assessment of chronic pain in a scholarly overview written with Joel Katz, a psychologist at York University in Toronto:

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