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Effect of environment on the long-term consequences of chronic pain

Bushnell, M.C.*; Case, L.K.; Ceko, M.; Cotton, V.A.; Gracely, J.L.; Low, L.A.; Pitcher, M.H.; Villemure, C.

doi: 10.1097/
Biennial Review of Pain

Much evidence from pain patients and animal models shows that chronic pain does not exist in a vacuum but has varied comorbidities and far-reaching consequences. Patients with long-term pain often develop anxiety and depression and can manifest changes in cognitive functioning, particularly with working memory. Longitudinal studies in rodent models also show the development of anxiety-like behavior and cognitive changes weeks to months after an injury causing long-term pain. Brain imaging studies in pain patients and rodent models find that chronic pain is associated with anatomical and functional alterations in the brain. Nevertheless, studies in humans reveal that lifestyle choices, such as the practice of meditation or yoga, can reduce pain perception and have the opposite effect on the brain as does chronic pain. In rodent models, studies show that physical activity and a socially enriched environment reduce pain behavior and normalize brain function. Together, these studies suggest that the burden of chronic pain can be reduced by nonpharmacological interventions.

Pain and Integrative Neuroscience Branch, Division of Intramural Research, National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA

Corresponding author. Address: National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), 35A Convent Dr, Bethesda, MD 20892, USA. Tel.: +1 301-496-2222; fax: +1 301-480-0772. E-mail address: (M. C. Bushnell).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received November 08, 2014

Received in revised form December 10, 2014

Accepted December 11, 2014

© 2015 International Association for the Study of Pain
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