Recent Studies May Hold Key to Chronic Pain Relief

04/12/99    Portland, Ore.

Recognition of emotional component may enable physicians to treat chronic pain--as in cases of fibromyalgia--more effectively.

New brain imaging techniques that allow physicians to trace the link between emotional states and specific brain functions are providing insight into the causes of chronic pain, according to Dr. Robert Bennett, M.D., F.R.C.R., a professor of medicine at Oregon Health Sciences University. These developments, as well as new treatments for fibromyalgia and other conditions that cause chronic pain, will be discussed at the Fourth Annual OHSU Women's Health Conference on Saturday, April 17 at the Oregon Convention Center.

In his conference seminar, "Understanding Chronic Pain and Fribromyalgia: A Review of Recent Discoveries That Help Explain Why You Hurt," Bennett will describe how a person's "emotional coloring" of pain can influence his or her overall sensory experience of pain. "Pain is a complex creature," explained Bennett, who is head of the Division of Arthritis and Rheumatic Diseases at OHSU. " The emotional aspects of having pain and how one rationalizes the problem influence the final experience of pain."

According to Bennett, research has shown that repeated exposure to painful stimuli, even at low levels, can result in a progressive buildup of pain that may feel greater than the sum of its parts. "This may be aggravated by emotional factors," he explained. "A patient who begins to believe that his or her pain may never go away is generating emotions and behaviors that are counterproductive to coping with a chronic problem."

This discovery has important implications for how health care professionals treat those who suffer from chronic pain ailments like fibromyalgia, a condition in which any movement of the muscles can create such intense pain that patient eventually becomes physically and psychologically withdrawn. "Fibromyalgia carries a host of emotional responses including fear, depression, anxiety, anger and helplessness. Many fibromyalgia patients can experience marital discord, vocational difficulties, chemical dependency, social withdrawal, sleep disorders, increasing fatigue, even a radical change in their previous personality," said Bennett.

"Fibromyalgia has been widely misunderstood both by patients and physicians," said Bennett, who has treated more than 5,000 fibromyalgia patients over the last 20 years. "Not long ago, complaints of chronic pain were treated suspiciously by physicians, as if they were merely figments of a fertile imagination. As a result, these patients often received little relief." He explained that such rejection was often devastating to the patient, which in turn tended to increase symptoms of pain.

Researchers believe fibromyalgia is caused by permanent changes in the function of the central nervous system, often as a result of arthritis or post-injury pain, such as pain from breast surgery or a car accident. "Fibromyalgia is not a problem that can be understood in terms of the classical medical model," Bennett pointed out.

Fortunately, Bennett added, new research is helping physicians diagnose fibromyalgia earlier and speeding efforts to manage chronic pain. Although there is currently no cure for fibromyalgia, new psychological and drug therapies can be effective in alleviating the emotional distress that accompanies long-term pain. "Managing one's emotional responses to chronic pain is vital for maintaining quality of life while living with fibromyalgia," said Bennett.

In addition to fibromyalgia, the latest treatment approaches to PMS, breast cancer, stress, menopause, osteoporosis and other health issues that affect women will be explored by nationally recognized experts at the Women's Health Conference. To register for the conference, or to receive a conference brochure, call the OHSU Center for Women's Health at 503 494-5309.