How Injury Changes You: Brain and Endocrine Loops

Here is a partial list of how pain changes your internal processes, from a very interesting article by Weisman and Masharawi. Chronic pain can result in ongoing dysfunction in the way you perceive pain as well as changes in molecular processes that are in addition to the ongoing tissue damage. The inflammatory activity related to injury can be self-perpetuating: inflammation that promotes more inflammation plus amplification of the experience of that inflammation. Part of Weisman and Masharawi's point is that we tend to be sympathetic about the broken bone, but judgmental about (or oblivious to) the altered pain and immune processing. The authors argue that with proper respect for the more ambiguous aspects of stalled healing, medical professionals should recognize the need to intervene before the loops get set in and perhaps even more importantly, the need to avoid patient blame. Subjective, as-yet poorly understood processes still pack a big punch.

[timing of the loop—that by the time the person comes in with chronic pain, the 'bad' loops are set]