Functional Connectivity Dr. Vachon-Presseau also studies how the brain processes pain. Using MRI technology, his team looks at how different regions of the brain communicate, exploring what he calls “functional connectivity.” In conditions like fibromyalgia, they’ve observed patterns of disconnection between brain regions involved in pain perception. This, he explains, supports a theory that fibromyalgia involves “amplifications from the brain,” a type of central nervous system overactivity. “It was interesting for us to see that there are structural differences within the brain related to these conditions,” he says. He describes this type of pain as nociplastic, arising from changes in the brain’s processing rather than from tissue damage or inflammation. “There are many biological manifestations of pain, of course,” he says, “but there’s also structural or macrolevel factors like socioeconomic status, education, smoking or drinking.” Pain, he emphasizes, is both a medical and a social experience. Education is correlated with less pain, and is also correlated with how people eat, exercise and access care. “Higher socioeconomic status is associated with lower pain,” he explains. “It’s not clear-cut, but people with more education tend to have better access to resources, to therapy, to ways of managing their pain.” At the same time, these same structural factors can make living with pain harder. Someone with limited financial means may not be able to afford therapy or time off work, and stress from economic insecurity and lack of social support can heighten the experience of pain. Dr. Vachon-Presseau also sees education itself as a form of treatment. In some pain clinics, he explains, clinicians “try to educate patients about their own pain, why they’re feeling it and what it means.” When patients learn that pain doesn’t always signal ongoing harm, their perception can shift. “Once you understand that there’s no real threat—that you’re not injured anymore, that your body is okay—and you start to reprocess how your brain interprets those signals, it can lead to improvements,” he says. Helping patients make sense of their pain, he adds, can ease the fear and anxiety that so often intensify the experience. Understanding pain requires understanding people; their biology, yes, but also their stories, stresses, and surroundings. Pain is not simply a signal from the body, but a reflection of a person’s lived experience. “These elements overlap and influence each other in complex ways,” Dr. Vachon-Presseau says, describing the weave of physical, psychological, and social threads that shape how pain is felt. Pain is both a medical and a social experience. Education is correlated with less pain, and is also correlated with how people eat, exercise and access care. Reference: Fillingim M, Tanguay-Sabourin C, Parisien M, Zare A, Guglietti GV, Norman J, et al. Biological markers and psychosocial factors predict chronic pain conditions. Nat Hum Behav 2025 Aug;9(8):1710-25. 24 | 2025 | Issue 6 Issues and People
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