Josephine P. Briggs, M.D.
The Brain and Pain
I recently had the pleasure of speaking with Wall Street Journal columnist Melinda Beck for her article, Rewiring the Brain to Ease Pain, a thoughtful piece on new directions in pain research. This article raises many important points. In the 12 years since NCCAM was established, integration of complementary health practices into our health care system has gained substantial momentum, driven at least in part by the research supported by NCCAM. A major area where complementary health practices are showing promise is in the management of chronic pain.
While there has been enormous progress in medical management of chronic pain, needs for improved strategies remain. For many conditions, and for many individuals suffering from chronic pain, conventional medical approaches provide incomplete relief. Furthermore, a high rate of adverse effects accompanies pharmacologic treatment with non-steroidal anti-inflammatory drugs or opioids.
Last week, Dr. Sean Mackey of Stanford University was our annual Stephen E. Straus Distinguished Lecturer. He reminded us that chronic pain affects some 116 million Americans and costs our economy $630 billion a year in medical expenses. Behind these statistics are individuals who are suffering every day with pain. Dr. Mackey presented fascinating examples to show how the brain responds to the experience of pain and how cognition, context, mood, and individual differences can affect pain intensity and response.
Also last week, the American Pain Foundation launched a new module as part of their PainSafe initiative on the use of complementary approaches to manage pain. NCCAM was pleased to collaborate with APF on this important educational tool.
The study of the brain opens new areas of discovery for us in learning about many complementary approaches to health and well-being. I am very intrigued about the potential of modern neuroscience to uncover insight into such questions as: Why can a pill placebo, a reassuring voice, or the expectations elicited by the ritual and counter-irritant effect of the acupuncturist—why can all these things so profoundly modify pain? And I’m eager to tackle the difficult problem of figuring out how these effects can be utilized to benefit patients in pain.