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The culprit of chronic pain was found to be hyperexcitability
Last reviewed: 01.07.2025
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American scientists have proven that a person’s emotional reaction can cause chronic pain. The results of the work of a group of researchers led by Professor Vania Apkarian from Northwestern University were published in the journal Nature Neuroscience.
Chronic pain is generally defined as pain that lasts longer than the normal healing period, lasts more than six months, and does not respond to medications that are effective for acute pain caused by injury. Apkarian and his colleagues have been trying to understand what causes chronic pain for about 20 years. In their early studies, they found brain changes that were characteristic of patients who developed the condition. However, scientists did not know whether these changes were the cause of the pain or whether certain areas of the brain were being transformed by long-term pain.
For their study, the scientists selected 39 people who experienced moderate lower back pain after an injury, as well as a control group of healthy people. All volunteers underwent brain scans four times over the course of a year, the state of which the researchers compared with the dynamics of pain sensations. After a year, 20 patients were completely healthy, while 19 of them continued to suffer from chronic pain.
Apkarian notes that initially the pain intensity was the same for all patients. Gradually, 19 volunteers developed chronic lower back pain.
In volunteers with chronic pain, scientists found unusually close connections between the prefrontal cortex, which is responsible for emotions, and the nucleus accumbens, which is part of the so-called pleasure center. According to the results of the scans, these two brain areas worked together in these patients. Based on how closely the prefrontal cortex and the nucleus accumbens interact, scientists can predict with 85 percent accuracy whether a patient's acute pain will become chronic or not.
In an interview with The Telegraph, Apkarian said that this research will also help establish a link between the development of chronic pain and a person's tendency to develop bad habits, for which the pleasure center is responsible. "We believe that the mechanism for the development of chronic pain is akin to the mechanism for the development of bad habits," the professor noted.
The professor believes that for chronic pain to develop, pain sensations arising as a result of injury are not enough; a certain emotional state and a tendency to increased excitability are also necessary.