The Neuroscience of Pain.
A fundamental paradigm shift is underway in our understanding of how chronic pain develops and what factors influence the experience of pain. Recent discoveries in the field of pain neuroscience reveal fundamental differences between acute and chronic pain conditions, and the “pain signature” each makes in the brain. When pain persists for more than 3-6 months, changes occur in the brain, spinal cord, and nervous system (a process referred to as “Central Sensitization”). As pain becomes “chronified,” these changes amplify the experience of pain and cause the brain and nervous system’s “Danger-Alarm” system to become overly sensitive (amplifying existing pain and even turning
“neutral” sensations into painful ones).
The longer pain persists, the more ingrained these changes in the brain become and the less useful pain is as a true indicator of ongoing structural damage. Like a malfunctioning smoke alarm that beeps incessantly, the alarm signaling danger and pain is excruciatingly real, but the actual threat is not. Left untreated, chronic pain increasingly takes on a self-perpetuating “life of its own,” irrespective of the original injury, degenerative process, or other trigger.
New Hope for the Treatment of Pain
Fortunately, just as the brain and nervous system can “learn” pain, so too, can the brain “unlearn” pain. New therapeutic counseling interventions based on the neuroscience of pain have evolved to target and treat the underlying abnormal processes that can fuel chronic pain. Well-designed research studies demonstrate that these cutting-edge Mind-Body Treatments (sometimes referred to PRT, or “Pain Reprocessing Therapy”) can significantly reduce, or in some cases, eliminate chronic pain.
These treatments draw from a wide range of established therapies, such as CBT, Acceptance and Commitment Therapy (ACT), Somatic therapy, Mindfulness-based Stress Management (MBSM), and “Pacing and Graded Exposure” experiences to increase tolerance for movements and activities associated with fear and pain.
PRT also involves Pain Neuroscience Education (PNE) so that patients better understand the underlying processes that fuel chronic pain, and addresses lifestyle factors that are directly impacted by pain (and have the potential to reduce or exacerbate pain). Examples include such things as sleep, mood, nutrition and levels of systemic inflammation, identity, purpose, relationships and social networks, hobbies, and physical activity.
Pain Counseling at Spine West
Spine West offers Pain Neuroscience Education ( PNE) and Chronic Pain Counseling at its Boulder office. These services are offered by Carol Bandura Cowley, MSN, APN-BC. In addition, Carol serves as a “Resource Navigator,” helping patients access additional services and resources, as needed (e.g., referrals for group pain counseling, individual psychotherapy, medical hypnosis for pain and chronic headaches, warm-water therapy or gentle movement classes).
Carol works closely and collaboratively with the medical providers at Spine West. Pain Counseling services are treated as medical visits and billed directly to insurance by Spine West (co-pays and deductibles may apply). During the Pandemic, these services are being offered remotely, as telemedicine visits. (Note: in her position at Spine West, Carol does not prescribe opioids or other medications for pain. She can review patients’ current medication regimen and screen for “polypharmacy,” in cases where multiple specialists are part of a patient’s care team.)
To Schedule a Pain Counseling Appointment
Pain Counseling visits are available to established Spine West patients who have had a least one visit with their Spine West provider in the last year. Patients who are new to Spine West can request a referral for Pain Counseling following an initial consult with one of the physicians or PAs at Spine West (to rule out any urgent structural problems or progressive neurological “red flags” requiring additional medical evaluation).
Patients wishing to schedule an appointment for Pain Counseling can do so by calling the front desk at 303-494-7773.