The Pain Matrix in Chronic Pain States

Last updated: Fri, Feb 28, 2025

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How the existence of chronic pain affects the brain's processing of pain.

Title Memo

Need to research the Schweinhardt et al. 2009 study referenced on Apkarian et al. 2013, p. 124.

End of included memoes/notes

The brain changes in at least six ways in the development of chronicity:

The areas in the pain matrix become more active.
Additional area is added to the pain matrix.
Structural changes occur in the brain.
The default network (the network of brain areas that are active when the brain is awake and at rest) is disrupted.
Areas of the cortex are reorganized and “maladaptive” plasticity occurs as the result either of increased or decreased peripheral input.
The chemistry of parts of the brain is altered.1

(I quoted the word "maladaptive" above because it seems teleological to me. I believe that a more appropriate term would be "harmful.") Our bodies don't react adaptively or maladaptively to serve or thwart our personal interests, they react in the way that they are built to react.

Much of the research that has lead to our picture of the pain matrix has been done using acute pain scenarios. How different is pain among chronic pain patients? We know that the same brain areas are activated among CPPs as among normals.2 There are differences, however.

Within this section...

Functional Alterations in the Pain Matrix Under Chronic Pain (Last updated: Fri, Feb 28, 2025)

Structural Alterations in the Pain Matrix Under Chronic Pain (Last updated: Sun, Mar 2, 2025)

Chemical Alterations in the Pain Matrix Under Chronic Pain (Last updated: Tue, Mar 4, 2025)

Or skip to...

Pain Phenomena Involving the Brain (Last updated: Sun, Mar 9, 2025)