Recent findings suggest that being naturally more sensitive to pain may indeed be a real phenomenon. Researchers from Asian University conducted a study on chronic pain patients and discovered that individuals with smaller amygdalae—a brain region associated with fear and anxiety—are more prone to heightened sensitivity to physical sensations.
This heightened sensitivity can even result in the perception of pain without any external stimulus. The findings were published in the renowned journal Pain Medicine.
Understanding Chronic Pain and the Role of the Amygdala
Chronic pain affects over 1.5 billion people worldwide, as reported by the American Academy of Pain Medicine in 2020. Defined as pain persisting for more than three months, chronic pain includes symptoms like stabbing sensations, burning pain, persistent aches, and electric shock-like discomfort, often coupled with stiffness or tightness in affected areas.
The amygdala, central to regulating fear and anxiety, plays a significant role in this process. When the amygdala is smaller, it tends to overcompensate by becoming hyperactive. This overactivity can suppress rational thinking controlled by the prefrontal cortex, leading to mood disturbances, irritability, and heightened stress levels, which further exacerbate the perception of pain.
Two Common Types of Pain Responses
Lin Zhi-Long, Vice President and Neurosurgery Director at Asian University's affiliated hospital, observed that certain post-operative patients reported chronic pain, severely impacting their quality of life. Collaborating with the hospital's Spine and Pain Center and Clinical Psychology Center, his team studied over 200 chronic pain patients using physiological feedback tools to record heart rate, autonomic nervous system responses, and brainwave activity. Two key pain response patterns emerged:
1. During stress periods, physiological signals indicated relaxation, while rest periods triggered high anxiety responses.
2. Simulated sleep states showed overactivity in the prefrontal brain region, indicating heightened mental engagement even during supposed rest.
The Connection Between Smaller Amygdalae and Pain Sensitivity
According to Ye Pin-Yang, Assistant Professor of Psychology and Clinical Psychology Center Director at Asian University, these findings relate to "catastrophic pain thinking." Chronic pain patients often exhibit hypersensitivity to sensations, interpreting minor or absent stimuli as pain. This anticipatory reaction creates psychological pain rather than purely physical discomfort.
Meta-analysis further revealed that individuals with chronic pain generally have smaller amygdalae, particularly on the right side. To maintain functionality, these smaller amygdalae become hyperactive, leading to misinterpretation of sensory input and amplification of pain perception. This suggests a link between reduced amygdala size and heightened pain sensitivity.
Treating Psychological Pain with Cognitive Behavioral Therapy
Experts Lin and Ye emphasize that effective chronic pain treatment must address both physiological and psychological aspects. Cognitive Behavioral Therapy (CBT) can help patients reduce catastrophic thoughts about pain by encouraging them to re-examine sensations and differentiate between actual pain and false alarms. Repeated practice can loosen rigid pain-related beliefs, foster flexible thinking, and shift focus to other aspects of life beyond pain.
Additionally, biofeedback techniques can help alleviate physical tension. By using devices to monitor physiological indicators like brainwaves, breathing, and heart rate, patients learn to regulate their bodies into a relaxed state. With consistent practice, patients can better manage physiological discomfort during real episodes of pain, ultimately reducing its overall impact.
This groundbreaking research highlights the intricate link between brain structure and pain perception, providing valuable insights for improving chronic pain management.
