Unraveling the Connection: Cancer, Chronic Pain, and Cognitive Function-Written by Doreen Bridgman MS,CCC,SLP-CBHC

                                                               


Understanding Chronic Pain

Chronic pain is defined as pain lasting more than three months. According to the Centers for Disease Control and Prevention (CDC), nearly 21% of the U.S. population—51.6 million adults—live with chronic pain. Of these, 17.1 million experience high-impact chronic pain that significantly limits their ability to work or participate in daily activities. Among cancer survivors, the prevalence of chronic pain is even higher. A study by Mount Sinai researchers, published in JAMA Oncology (June 2019), found that about 35% of cancer survivors (5.39 million people in the U.S.) suffer from chronic pain, nearly double the rate of the general population.

The Impact on Cognitive Function

Chronic pain doesn't just affect the body; it also impacts cognitive function. As a Speech Language Pathologist and Certified Brain Health Coach, I’m addressing this because of the vital link between chronic pain and cognitive decline.

Research shows that the neural systems for cognition and pain are closely connected. Pain is not only a physical sensation but also involves cognitive processes like evaluation, learning, recall of past experiences, and decision-making. Chronic pain leads to several changes in the brain, particularly in areas related to cognitive processing, such as the prefrontal cortex and hippocampus. It also causes neuroinflammatory responses, disrupting neurotransmitter systems like dopamine and serotonin, essential for cognitive function. These changes result in cognitive deficits, including:

-Attention: Chronic pain impacts the brain's attention system, making it harder to focus and filter out irrelevant stimuli. Pain sensitivity may decrease when distracted by other tasks, but older adults are less able to use this coping mechanism, affecting their independence.

  - Memory: People with chronic pain often report issues with working memory, recall, and recognition. This is likely due to the overlap between attention and memory functions.

- Executive Functioning: Chronic pain impairs skills such as planning, organization, and decision-making. Age-related reductions in gray matter are accelerated in chronic pain syndromes, worsening these deficits.

- Processing Speed: Chronic pain slows verbal reaction times and psychomotor speed.

Emotional Well-being

Chronic pain also affects emotional health. It triggers the body's stress response, releasing cortisol, which when elevated for long periods, can further reduce cognitive processing. Anxiety and depression are common in people with chronic pain, exacerbating cognitive decline.

Managing Chronic Pain

Addressing chronic pain involves more than treating the physical symptoms; it requires a comprehensive approach that also considers cognitive and emotional impacts. Effective management includes:

- Pharmacological interventions to reduce neuroinflammation and support neuroplasticity.

- Mindfulness-based stress reduction and cognitive-behavioral therapy to address emotional effects.

- Cognitive rehabilitation, education, and brain training to mitigate cognitive decline.

A team approach is essential for comprehensive chronic pain management, addressing all aspects of a person’s life affected by pain.

Visit longliveyourbrain.com to learn more about managing cognitive challenges related to chemobrain.

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