One of the reasons I am so optimistic about the future is that someday I believe we will have a way for doctors to see just how much pain a person is in. It won’t be a matter of taking the patient’s word for it (though that should be enough) or wondering whether or not a patient is faking it. Instead, there will objective results right on the screen.
What I am talking about is functional magnetic resonance imaging, or fMRI. An fMRI is slightly different from what most people think of as an MRI.
A regular MRI takes “snapshots” of what is going on in the body. Your doctor might send you for an MRI of your spine if you are suffering from back pain. Sometimes women have breast MRI’s if something odd shows up on a mammogram. An MRI shows you what is happening in the body at a particular moment in time.
An fMRI, on the other hand, is a way of looking at blood flow in the brain. It shows which parts of the brain are more active than others. Because the more active parts of the brain require more oxygen, an fMRI will show increased blood flow to those areas.
Researchers working with fMRI have been able to identify distinct patterns of brain activity in the brains of chronic pain sufferers. These patterns of activity set chronic pain sufferers apart from normal, healthy individuals. These distinct patterns are unique to people with chronic pain and are sometimes referred to as a “pain phenotype.”
I have heard of several research groups in the US who are investigating whether or not pain sufferers can learn to “rewire” their brains using the information given in an fMRI. This is done by using a form of biofeedback. There is evidence to suggest this can be done. (If you would like to know more about biofeedback, check out these great explanations by Christopher DeCharms and Dr. Sean Mackey).
I’ll be writing more on the idea of biofeedback in a later post. For now, the fact that an fMRI can even show pain activity is exciting to me. In a world where chronic pain/fibromyalgia patients are routinely pushed aside, dismissed, and belittled, fMRI offers us all hope.
People who really understand pain know that it can be a disease in its own right. Once a person’s nervous system gets wound-up enough (yes, “wind-up” is actually one of the scientific terms that refers to this process), the pain can be out of control, and no longer in proportion to whatever physical injury might have originated it.
With brain imaging, this phenomenon will become more clear. Perhaps someday, pictures of the “pain phenotype” will appear in everyone’s medical school textbooks. A sympathetic doctor won’t be something we have to travel far and wide for, like the pot of gold at the end of the rainbow. Pain will be understood as a disease in its own right, and perhaps then adequate pain medication can actually be given.
Or… who knows. Maybe pain patients won’t need as much medication because instead, we will be able to learn to control the pain-processing parts of our brains using biofeedback.
Either way, I am optimistic!
For more information, you can check out a new page in my Resources section called “Brain Imaging for Chronic Pain.”
**Ok, so this photo is actually a picture of someone’s heart, but it looks a lot like the fMRI’s I’ve seen in documentaries. I know there are better pictures out there, but I get nervous about that whole copyright infringement thing, so for now I’m sticking to what I can find in Creative Commons. Thank you to Glyn Nelson.**
Above rainbow picture courtesy of SugarBear1956 on Flickr