Understanding the Terminology of Mind-Body Medicine and Chronic Pain

A scientific appreciation of the interplay between mind and body is relatively new to Western medicine, and as such various authors have used different verbiage over the years. Terminology is now becoming more consistent, but there is still a hodgepodge of interrelated jargon to sift through. For patients, a clear understanding of the true source of their chronic pain is an important step in the healing process. Knowledge is power!

Please read on for an explanation of commonly used terms:

Psychophysiologic disorder: a health condition in which mental processes alter the function of the body, causing chronic pain and/or other symptoms. It is important to note that such disorders (1) typically do not cause any permanent structural damage to the body, and (2) are fully treatable with the right techniques.

Mind-Body Syndrome: see the above. This term is synonymous with psychophysiologic disorder. It emphasizes the fact that such symptoms are real, as opposed to imagined. Also highlights the inherent interconnectedness of mental and physical states.

Neuroplastic pain: a broad term encompassing psychophysiologic chronic pain syndromes. Neuroplasticity refers to neural learning, which indicates a learned process due to an overly sensitized brain and nervous system. Since it is learned, it can also be “unlearned” or reprogrammed.

Chronic Primary Pain: see above. Chronic primary pain is synonymous with neuroplastic pain. The International Classification of Diseases 11th Revision (ICD-11) defines chronic primary pain as “when pain has persisted for more than 3 months and is associated with significant emotional distress and/or functional disability, and the pain is not better accounted for by another condition.” Fibromyalgia, complex regional pain syndrome, chronic primary headache and orofacial pain, chronic primary visceral pain, and chronic primary musculoskeletal pain are all appropriately categorized here. The international medical community’s recognition that these syndromes are not caused by tissue damage in the body is a huge step forward for practitioners of mind-body medicine.

Central Sensitization: the process by which neuroplastic pain develops. Altered brain function in chronic pain patients, as measured on functional MRI scans (fMRI) and electroencephalography (EEG), provides evidence of this process.

Hyperalgesia: one of the manifestations of central sensitization in which painful stimuli are felt more intensely and/or over a larger area of the body than they otherwise would be.

Allodynia: another manifestation of central sensitization in which pain is perceived due to stimuli which would normally be non-painful.

Tension Myoneural Syndrome (TMS): also sometimes called “tension myositis syndrome.” This is a common type of neuroplastic pain, which is usually associated with muscle pain, muscle knots or “trigger points,” and nerve irritation symptoms such as radiating pain, tingling/numbness, and even in some cases weakness. Fibromyalgia is thought to be a more severe manifestation of this condition. A qualified physician can help patients rule out structural causes of similar symptoms, and rule in this treatable and benign disorder.

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Patient education is foundational to the treatment of neuroplastic chronic pain (AKA primary chronic pain or pain due to central sensitization). Karuna Labs’ Virtual Embodiment Training (KVET)™ virtual reality program is bolstered by a network of practitioners specializing in education, diagnosis, and synergistic treatment modalities. We look forward to assisting you in your healing journey.

Contributed by Theodore Armstrong, MD for Karuna Labs. Original publish date 7/7/2022.