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CommonEar474 t1_ixb9qna wrote

I can’t speak much on the stomach contractions. I imagine they are a result of spasming muscles and your body wanting to get stuff out… BUT

As a pain neuroscientist I can speak generally on the pain felt in the stomach. Interestingly, visceral pain (pain of organs) is communicated to the brain with these really messy nociceptive (pain) paths. With this, descriptive location accurate visceral pain is not very evolutionary necessary. So visceral pain is almost never reflective of it’s quality or location. This is why bloat can burn and stomach ulcers can feel like you’ve been punched. It’s also why heart attacks (a pain causes by lack of oxygen) can feel like an elephant on your chest, a knife or a burn.

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cristiano-potato t1_ixbjnkj wrote

That is super interesting. I have a chronic pain condition and I’ve always wished we understood it better so it could just be cured

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CommonEar474 t1_ixdlhn9 wrote

Hopefully the research I do will help! Not to get to into it too much but what I want to do is understand how systems that represent negative affect (feeling bad) become disordered in addiction, anxiety and chronic pain. A lot of time chronic pain is a result of abnormalities in the brain that cause a persistence of negative affect… it becomes nearly impossible to not constantly think about your pain and feel awful. This is why cbt and meditation can be so helpful. I want to figure out how these systems that generate our affective awareness work.

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cristiano-potato t1_ixdn3q8 wrote

I’ve seen relief from migraines with supplements like B2 that are known to impact mitochondrial function but you’re the expert I dunno what else might be going on.

But absolutely yes I’ve also seen that mindset change from things like meditation or therapy can seemingly sometimes literally reduce pain.

It’s no surprise I guess that migraine and anxiety are so often linked, although of course you have to ask if it’s due to some underlying common etiology (word?) or whether it’s simply that chronic pain induces a state of fear… probably a little of both.

Addiction, even if not literal physical dependence I think is common in migraine too… video games addiction or porn or whatever it is, seems very common…

You have no idea how much joy you could spread to the world in figuring these things out, probably over a billion people are suffering from chronic pain and just want it to end, Godspeed to you I wish you the best, many of us need help

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CommonEar474 t1_ixe5fdx wrote

I think the reason there’s so much overlap between chronic pain, anxiety, depression, addiction… is because pain is, among other things, an emotion. More specifically it is an emotion driven by internal sensations.

To understand this overlap let’s take anxiety as an example. Imagine you are walking home and want to take a turn down an alley that will get you home faster. Your stomach drops, and you decide it’s best to take the long way. Here a sensory experience led to negative affect (anxiety) that turned you away from a bad choice. In an anxiety disorder however, an individual is hyper sensitive to changes in their body— this means that this negative affect/anxiety is likely to come up a lot more often when it’s unnecessary

In pain, a painful experience leads to a negative affective state, the kind that might make you feel awful, groan or cry. In a typical situation this negative affect might help you, it may, for example keep you from playing soccer when you should be healing. But In chronic pain we (just like anxiety!) become overly sensitive to signals in our body and we become a lot more likely to produce negative affect. This means instead of helping us chronic pain serves virtually no purpose. Right now the best way to address this cognitive/affective aspect of pain is through therapy or meditation but in the future there may be drugs that allow you to blunt these processes. This would mean that you could be aware of pain with out feeling bad because of it. Actually this has been achieved through deep brain stimulation in like 1 person… we’ll see where that goes.

Hope u enjoy my infodump. I’m obsessed with this (and further implications into how these affective systems play a role in social cognition)

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cristiano-potato t1_ixe9sc5 wrote

Yeah I mean I’ve followed a lot of the research and what you’re saying makes some sense but also is obviously a bit of a simplification right — theories about migraines talk about signals misprocessed as pain, or over-sensitization, but also mitochondrial dysfunction or even things as simple as TMJ causing tension which triggers a migraine after a tension headache… it seems like it’s a complicated picture since some people respond to certain therapies but not others…

I also wonder how much you’ve researched about dopamine imbalances. One thing I’ve wondered is how much pain or anxiety could have to do with compulsive, addictive behavior that is often used to get a rush when one is feeling down. I’ve read theories that things like anxiety or migraines are sometimes linked to dopamine issues. Maybe if someone is frying those receptors by constantly stimulating them, whether it’s hardcore porn or just their favorite video game for 8 hours a day, could they be impacting how their brain processes other info?

And in that case, maybe for some people it’s as simple as “stop doing those things and let your brain readjust to a lower level of dopamine”. And in this case, I’d think difficulty actually stopping could be indicative of finding a source of a problem right? If someone is experiencing chronic pain for example, and tries to stop doing certain behaviors because they think it may be a causative factor, but despite their brutal pain they’re unable to stop (I know someone like this) it makes me think — okay that’s truly addictive behavior. If you are literally disabled by your pain and the prospect of being pain free isn’t enough to prevent you from seeking that high, you’re hardcore addicted.

There’s a shocking dearth of research on addictive behaviors, their correlations with chronic pain conditions, and the association between cessation of the behaviors with reduction in pain levels. I can’t find a single study that, for example, took a group of pain sufferers, compared their internet surfing behaviors with a control group of pain free people, then attempted an intervention of stopping the surfing, and measuring the effects of that.

Just food for thought. I’d personally like to think pain levels are something we can modulate with behavior, and someone with pain isn’t simply doomed to always be overly sensitive. I’d like to think we can make lifestyle choices, even things as simple as getting good sleep, that will lower that threshold

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CommonEar474 t1_ixes7yb wrote

Absolutely a simplification (kinda gotta do that when you look at the brain). Affects the part I wanna look at though.

I’m actually doing addiction research now too and think that addiction is similar to chronic pain in that it results in this increased affect — people with addictive disorders feel strong cravings they can not crave, they over emphasize the good feeling on the drug and perhaps most importantly they feel awful when withdrawing. Withdrawal causes increased sensitivity to pain and negative affect and likely drives addictive behavior.

Real interesting stuff

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cristiano-potato t1_ixezapc wrote

Hmmmm, but what about before withdrawal, during the addiction phase? Can that cause pain issues?

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cristiano-potato t1_ixeh9nt wrote

> This would mean that you could be aware of pain with out feeling bad because of it.

Also just wanted to mention — this is the theory of mindfulness and meditation which is perhaps why it has seen some success. You can genuinely be aware of pain but experience it without suffering.

The proof is in the pudding right? We’ve all seen that photo of the Buddhist monk sitting still while burning himself to death.

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PM_CACTUS_PICS t1_ixc23y9 wrote

Why does pain spread to non affected areas sometimes? For example period pain spreading and feeling like it’s coming from the legs

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totalimmoral t1_ixcpa6y wrote

I know the answer to this one! It can actually be a several things but its most likely to be complications with endometriosis. It could have spread to press on your sciatic nerve or your ovaries (which share some nerves with your legs.)

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CommonEar474 t1_ixdse0u wrote

Definitely an example of messy pain signaling. Pain can also generally increase sensitivity to pain or negative affect so being in consistent pain on your period might just make other pain more salient to you. There are some other reasons why visceral pain is poorly localized but it’s hard to get into in a comment

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Deedle-eedle t1_ixcziq5 wrote

What about menstrual cramps? Why do I feel like I’m getting stabbed in the stomach and someone is twisting the knife? 😭

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starry_flower t1_ixd6tzw wrote

When you start your period, your endometrium begins to slough off since no egg has been fertilized. At the same time that your endometrium is shedding, prostaglandins are released. These prostaglandins play a role in the contraction of the uterus in order to adequately shed the endometrium for the current cycle. With these contractions, people can have pain, especially if someone's uterus contracts frequently. There's also thoughts that certain stretch receptors can get activated when this happens, and that can also contribute to pain.

TLDR; a chemical is released when you start your period that causes your uterus to contract and that hurts

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Deedle-eedle t1_ixdo4xk wrote

Thank you for the explanation. Loathe the body for punishing me for no baby

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Maximum-Space7660 t1_ixdbwmd wrote

I uh think I have a stomach ulcer after reading this. I’ve been having these attacks that feel like i’ve had the breath knocked out of me that last 10-45 mins and it’s severe and it stops with zantac and phenergan. Yikes

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Jake420theslut t1_ixdgp2v wrote

Hey pain neuroscientist. I'm so glad you said this and especially the last part. I've been getting sharp stab pains on my chest come and go for years at random times, very sparsely; but here's the problem I'm a teen! And this has been happening since I was 13 normally I'd be concerned it's angina , but I'm so very young. Checkups aren't really so available.. would be quite expensive af I Imagine

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CommonEar474 t1_ixdqzz4 wrote

Yeah please don’t interpret anything I say as medical advice. If anything what I’m saying is not to trust the locality and quality of your pain. I have had an esophageal ulcer and thought I was having a heart attack.

Also (again don’t trust my advice and please go to a doctor if you’re concerned) it could be precordial catch syndrome (I experience this) or costochondritis.

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