Resource Elements

  1. The changes in chronic pain treatment prompted by questions asked inside a major healthcare organization.
  2. A glimpse of efforts to translate neuroscience discoveries into effective clinical practice.
  3. The importance of tailoring the therapy to the patient, because only the patient can change their neural networks.
  4. Therapy needs to feel good to the patient.
  1. The costs of chronic pain to our society are large.
  2. Most chronic pain is related to unrealistic neural pathways rather than tissue damage.
  3. Healing chronic pain involves effort by the patient.
  4. Translating effective therapies from the laboratory to the clinic is happening.

Dr. Ranes specializes in applied neuroscience, i.e. taking new insights about how the brain operates from the laboratory, then doing the research and development work to make sure new clinical treatments and therapies are actually beneficial for patients with chronic pain.

The world of ‘Chronic pain’ found her while she was working for United Health Care.  Her task was to find insights to reduce the cost of chronic pain treatments.  She found about 21% of the population will deal with chronic pain sometime in their life.  The annual costs in the US related to chronic pain are over 500 billion dollars, and the pain can be debilitating for an individual.

She found that chronic pain was not significantly correlated with bodily damage, 80 to 80% of chronic pain has no clear structural cause.   However, laboratory MRI image studies of human brains showed chronic pain is correlated with life experiences that prompt a person’s brain to predict a threat of injury when no actual threat is present.

So, she started what she called ‘The Brain First Pain Clinic Experiment’ (in Las Vegas in 2020) where patients were referred by their medical doctor when no structural damage could be found.   Some clinicians had resistance to the possibility that a brain-centered therapy could provide realistic benefit and would not refer patients, so their patients were the control group.

The Clinic used therapies to help the patient reprogram their brain pathways away from unwarranted threats and therefore away from the pain (and other symptoms the brain uses to get the owner’s attention to change the situation that presents a perceived threat).  It worked, but the clinic was too small to meet the demand.

Her mission at is to scale the effective concepts from that Experimental Clinic into a format that will be embraced by future clinicians and patients.  To be effective, brain-based clinical elements need to have high engagement with both patient and the clinician, but the results are not instantaneous.  So, the therapy needs to continue long enough to change the neural pathways in the patient’s brain.

That means to do well in the mainstream setting, the therapy has to feel good to do, all by itself.  It is a really big journey to reprogram neural pathways and that has to be important to you, the patient.  The focus needs to be on the specific value for that person doing the reprogramming.

She recommends two books:  ‘Atomic Habits’ by James Clear and ‘Tiny Habits’ by BJ Fogg on concepts for making things really convenient and ‘sticky’.

Finally, she offers Bonus Tips around the concept of neuroplasticity (changing neural pathways).  Think of your most used neural pathways as regularly used freeways, but some take a high-threat route.  Building a low-threat route is like finding an alternate path through the adjacent woods to avoid the high-threat route.  Each attempt at a new neuron pathway builds a more serviceable alternate route.

Reducing the stress in your life, perhaps using meditation and mindfulness (e.g. Sitting with your mind to understand and accept its patterns.) helps you find new ways of thinking about the new route and a new belief system about the cause of your pain.  Getting enough sleep is super critical.

She writes a neuroscience blog ‘Firing and Wiring’ on and invites questions.

Views: 21