Cognitive processes and chronic pain

Cognitive processes and chronic pain

According to the criteria of the International Classification of Diseases ICD-11, the chronic pain it is one that manifests itself in a latent or persistent manner for three months or more; different investigations show that when it manifests for a long time the pain can affect the performance of mental activity, that is, of certain cognitive processes, increasing in the individual states of uncertainty, anxiety, fear and confusion, adding this to the discomfort caused by the debilitating symptoms that are related to chronic pain.

Why does it hurt and what keeps your pain? Is it hard for you to focus your attention on a specific task? Have you felt that your short-term memory fails you a bit? It is possible to improve each of these aspects through cognitive training.

What function does pain have? It contributes to survival, since it perceives relevant stimuli to which it classifies as threatening, directs attention and chooses an answer, warns us about something that is relevant to pay attention to, it is a call from our body, when these are not heard signals, it is feasible to decline the welfare of the individual.

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  • 1 What cognitive processes can be affected by chronic pain?
  • 2 “Modeling” of pain
  • 3 Motivation and Cognition
  • 4 EA: In Action with cognitive training
  • 5 Benefits of reading in patients with chronic pain

What cognitive processes can be affected by chronic pain?

Attention and memory

It has been observed that patients suffering from chronic pain experience deterioration in your working memory, is the one that helps us to encode and process the information we receive, so this process can be complicated. The difficulties in focusing attention In certain tasks, it also has a prevalence among those who suffer from chronic pain. Cognitive processes can get more complicated when the patient is under a lot stress and manifests high levels of anxiety. Catastrophism, for example, affects memory and attention, (Grisart and Vanderlinden, 2001).

Sensation and perception

When a pain is persistent, central sensitization (SC) can be manifested, as there is an increase in neuronal excitability, the areas affected by the pain expand, leading to qualitative sensory disorders such as allodynia and hyperalgesia.

The neurologist Jordi Montero (2018) suggests for patients with chronic pain the caresses and massages, because they interfere with the sensation input mechanism. Massages should be those that are approved by your treating physician or a trained physiotherapist.

The cognitive evaluation represents an important element, is the way the person perceives pain and personal beliefs regarding their abilities, in the clinical praxis the affective and sensory intensity that the patient manifests over time is valued, since they are associated.

It is useful to reinterpret pain sensations that are inconsistent with that experience, whether using the imaginative resource or through suggestion, as in the case of hypnosis and other programming techniques at deeper levels of consciousness: alpha, beta, gamma, delta and theta, the cognitions regarding pain that are not suitable for the person are modifiable, the brain can learn to respond differently to certain stimuli. On a somatic and emotional level, the relaxation techniques.


Pain alters brain regions involved in cognition, the activation of the anterior cingulate cortex (CCA), is a cortical area that influences the learning of the aversive fear, of the pain perception, as well as the emotional discomforts linked to him; on the other hand, the inhibition of the activity of the CCA diminishes the chronic pain and the non grata responses that it produces (Tao Chen et al., 2018). The affective areas of pain are: insula, anterior cingulate gyrus and frontal cortex. Ramachandran et al. (2014), with their research on the pathophysiology and treatment of pain in phantom limbs as a post-traumatic sequel, they reached the following conclusion: "Reorganization is likely to occur not only in sensory areas of pain but also in affective areas of pain" .

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"Modeling" of pain

What memories do we build for our children daily? The human being imitates the expressions of his peers with the help of mirror neurons, keeping those memories in the body. Through social learning or “modeling,” the infant learns how parents and other social actors face pain. How do you deal with your pain? When there is chronic pain in the family, It is necessary to work on biopsychosocial factors so that “facing pain with an attitude of emotional suffering Do not transmit from generation to generation.

When parents express allergic pictures frequently, they can teach children how to face certain challenges, from small they can learn to be victims of circumstances or to be warriors who face the trials and challenges of life with a smile, the best attitude and the best adaptive strategies.

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Motivation and Cognition

Recent studies at the University of Texas in the United States show that dopamine typically associated with cognition, movement, reward behavior and motivation, among others, can also play an important role in promoting chronic pain.

So what can be done if there is suspicion of a decrease in cognitive performance?

EA: In Action with cognitive training

When chronic pain, along with other physical and / or psychological conditions are complicated, the individual may experience major changes in their life, for some patients it is a great challenge to adapt appropriately to their circumstances, so in the adjustment period the belief in self-efficacy may decrease, affecting the assessment of themselves and their self esteem, it is advisable to seek the help of a psychologist, because anxiety disorders and Mood as the depression, frequently prevail among these patients.

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Benefits of reading in patients with chronic pain

Reading represents an adequate means to handle the emotional and psychological difficulties experienced by patients with chronic pain, likewise with people who live other types of "captivity." A study conducted at the University of Liverpool by Josie Billington et al. (2017) compared orthodox therapy for chronic pain, with cognitive behavioral therapy (CBT), based on the specific intervention based on the literature, observed that participating in reading circles or taking shared readings has positive effects on mood and pain perception, in turn, this enriching activity involves working with cognitive processes.

Patients suffering from chronic pain can improve their cognitive skills in a fun and fun way, "get fit mentally”Represents an adaptive coping strategy. Marta Guerri Pons, a psychologist specializing in therapy with families with social vulnerability in the Family Counseling and Support Service (SOAF), wrote a book that represents a valuable resource for these purposes: "Mental training to improve your intelligence", in it you can Find fun exercises that will help you stimulate your cognitive skills.


As you can see, pain has emotional and cognitive implications. The brain is responsible for regulating the basic functions of the human being, having this important multitasking, tends to "mechanize" many responses, it does so with the help of different cognitive processes such as: sensory perception, attention, memory and learning, which are may be affected due to chronic pain, it is convenient for the person to be treated comprehensively, taking into account the psychological intervention.

It is recommended that the patient with chronic pain perform cognitive, behavioral training and learn to manage your emotions, In ci-training.com and puzzleclopedia.com, you can find exercises to do so and put yourself: "In Action" and dissipate a little anguish intelligently.