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Dr. Jason Winkelmann

Why Describing Chronic Pain Is So Difficult


chronic pain explained

Describing pain is an inherently challenging task. The struggle to articulate the nuances of pain is not merely a communication hurdle; it's deeply rooted in the intricate workings of our brain. Unraveling this complexity unveils a compelling narrative where trauma, the speech center of the brain known as Broca's area, and chronic pain intersect.


The Brain's Speech Architect: Broca's Area

At the core of our ability to express thoughts and emotions through language lies Broca's area—a speech center nestled in the left hemisphere of the brain. This critical region is often impacted in stroke patients, leading to difficulties in verbal expression. When blood supply to Broca's area is disrupted, the ability to articulate one's internal experiences falters.


Trauma's Impact on Broca's Area

Enter trauma, a powerful force that reverberates through the brain's neural pathways. Functional MRI scans have provided remarkable insights, revealing that trauma triggers a shutdown of Broca's area. The intriguing twist here is that trauma is predominantly processed in the right hemisphere of the brain, the "emotional" brain. As trauma takes center stage in the neural theater, the left hemisphere, housing Broca's area, often goes offline, making it rather difficult to verbalize how you are feeling.


Overlap with Physical Lesions

This visual evidence challenges preconceived notions about trauma's effects on the brain. The striking similarity in the functional MRI scans between trauma-induced shutdown and the impact of physical lesions, such as strokes, is a revelation. It underscores that the consequences of trauma are not inherently different from those of physical injuries; in fact, they can overlap and manifest similarly!


The Language of Pain Silenced

Understanding this intricate dance between trauma and Broca's area offers a profound explanation for the difficulty in articulating pain experiences. It's not a matter of lacking words or willingness; it's a physiological response to the dominance of trauma processing. When trauma occupies the stage, the brain prioritizes coping mechanisms, often leading to the temporary silencing of Broca's area.


It's Not Your Fault

This revelation carries a crucial message for chronic pain sufferers: It's not your fault that describing pain feels like an uphill battle. The intersection of trauma and Broca's area sheds light on the physiological foundation of this struggle. Acknowledging this connection dismantles the stigma associated with an inability to articulate pain experiences and emphasizes that it's a valid and common challenge.



Armed with this knowledge, chronic pain sufferers and healthcare professionals can navigate the landscape of pain more effectively. Describing pain is difficult even when you've been experiencing it for years. Not being able to describe your pain symptoms sufficiently can lead to poorer treatments. Having a chronic pain specialist on your team that understands this can help you get more effective treatments and put your chronic pain into remission.

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