When you have a chronic pain condition like fibromyalgia or chronic low back pain then areas of your nervous system controlling pain processing are working abnormally. The pain signals you experience are amplified more than usual and the areas that reduce the awareness of pain are less active.
If you are suffering from chronic pain, you experience pain messages about twice the intensity to the same stimuli as someone with normal function. This abnormal processing of pain information can result in you perceiving pain without any painful external stimulus to your nervous system.
Clinicians have often erroneously categorised patients with chronic pain conditions as having psychological problems, however a large majority people with these conditions are and remain psychologically normal. In people with chronic pain the brain areas involved with body sensation, attention and emotion all work normally. Specifically, the areas of the brain that are able to shut down pain (medial frontal cortex (MFC), mid/posterior cingulate cortex, and insular cortex) and in stress response areas are less active and dense than normal. It is thought that that the stress response areas are more active as a result of the pain, rather than causing it.
The MFC is thought to be stimulated by mental exercises such as the Stroop Test, verb generation, mindfulness of breathing meditation, self-reflection and self-generated action.
Several treatments have been found to be effective for helping chronic pain conditions such as: heated pool therapy (with or without exercise), tai chi, yoga, meditation, hypnosis, and guided imagery. A combination of different therapies (occupational, physical, and cognitive) therapy has been shown to be effective in treating people with fibromyalgia. Treatments including physical reconditioning, biofeedback, relaxation training, stress management, activity moderation, chemical health education, and reduction of pain behaviours helped participants significantly reduce their pain and make improvements in life control, social activity and general activity, and physical and emotional health. The same program significantly reduced the number of participants taking opioids, antianxiety drugs, non-steroidal anti-inflammatory drugs (NSAIDS), and muscle relaxants, none of which are effective in treating fibromyalgia.
Various medications have been found to be helpful for different symptoms of fibromyalgia but few have been found to help with chronic low back pain.
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