Pain threshold can be raised by altering brain chemistry, arthritis study claims

People can raise their pain threshold by altering brain chemistry, a UK study on arthritis patients suggests.

According to researchers from the University of Manchester, it has long been known that human bodies contain natural painkillers, such as endorphins. The team, for the first time, has shown that receptors in the brain could increase in number to help people cope with long-term, severe pain.

In the study published in the journal Pain, lead researcher Dr Christopher Brown and his colleagues said that the more opiate receptors there are in the brain, the higher the ability to withstand the pain.

To test the theory, the scientists measured the pain threshold of 17 arthritis patients and nine healthy controls by applying heat to the skin of participants using a laser simulator. The team then scanned the participants’ brains with a Positron Emission Tomography (PET) imaging to count the number of opiate receptors.

Arthritis patients who suffered more recent severe pain were observed to have more opiate receptors, according to the researchers. This suggests that the increase in opiate receptors in the brain is an adaptive response to chronic pain, allowing people to deal with it more easily, the team said.

“This is very exciting because it changes the way we think about chronic pain. There is generally a rather negative and fatalistic view of chronic pain. This study shows that although the group as a whole is more physiologically vulnerable, the whole pain system is very flexible and that individuals can adaptively upregulate their resilience to pain,” said Professor Anthony Jones, director of the Manchester Pain Consortium, which is focused on improving the understanding and treatment of chronic pain.

With the discovery, it may be possible that some simple interventions can further enhance this natural process, Jones said. He added that designing smart molecules or simple non-drug interventions to do a similar thing is potentially attractive.

Although the mechanisms of these adaptive changes are unknown, understanding ways on how to enhance them will lead to exploring methods to naturally increase resilience to pain without the side effects associated with many pain-killing drugs, the researchers explained.

Chronic pain, a condition which lasts for more than three months, is a real problem for many individuals worldwide. One in five Australians are reported to experience chronic pain that's serious enough to disable them, costing the country approximately $35 billion a year, according to Neuroscience Research Australia. People who experience chronic pain often struggle to find effective treatment and can experience disability and even depression.

However, the new study suggests that some people seem to cope better than others with pain, and knowing more about how these coping mechanisms work might help develop new ways of treating the distressing symptom.

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