[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-433773-105":59,"doc-detail-433773-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","chronic-pain-as-a-brain-disease-bridging-neuroscience-and-global-health-letter-to-the-editor","Chronic pain as a brain disease: bridging neuroscience and global health - Letter to the Editor","","Letter to the Editor arguing that chronic pain reflects profound neuroplastic changes in the brain rather than a lingering sensation. Drawing on Jaffal’s review, it explains remodeling of gray matter, connectivity, and key networks, linking these changes to persistent sensory and emotional impairment. It highlights the global burden and underdiagnosis in low- and middle-income settings, including the Philippines, and calls for neuroimaging-informed diagnosis, targeted therapies, early intervention, and accessible community psychosocial strategies while emphasizing further culturally diverse research.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/chronic-pain-as-a-brain-disease-bridging-neuroscience-and-global-health-letter-to-the-editor/433773/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/chronic-pain-as-a-brain-disease-bridging-neuroscience-and-global-health-letter-to-the-editor/433773.png","ImageObject",300,407,{"name":92,"@type":93},"Noah","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why does the letter argue that chronic pain is more than a symptom?","Question",{"text":112,"@type":113},"It states that persistent pain mirrors neuroplastic changes in the brain, including structural and functional remodeling that affects sensory and emotional processing.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What does the letter say about chronic pain in low- and middle-income countries?",{"text":117,"@type":113},"It notes that chronic pain is often underdiagnosed and inadequately treated due to factors such as stigma, cultural beliefs, and limited access to specialized care.",{"name":119,"@type":110,"acceptedAnswer":120},"How does the letter propose improving diagnosis and treatment?",{"text":121,"@type":113},"It emphasizes using neuroimaging-informed concepts to develop diagnostic markers and targeted therapies, combined with early intervention, training healthcare workers, and community psychosocial approaches like cognitive behavioral therapy, mindfulness, and graded activity.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},433773,1792668036,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},8796095462418,"https://ap-avatar.wpscdn.com/avatar/80000253c1241d02b47?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778826106357471780","Korean J Pain 2026;39(1):136-137 [https://doi.org/10.3344/kjp.25160](https://doi.org/10.3344/kjp.25160)[ ](https://doi.org/10.3344/kjp.25160)[pISSN 2005-9159](pISSN 2005-9159), eISSN 2093-0569  \n| \u003Cbr>Letter to the Editor\u003Cbr>Chronic pain as a brain disease: bridging neuroscience and global health\u003Cbr>Jose Eric Mella Lacsa\u003Cbr>Department of Theology and Religious Education, De La Salle University, Manila, Philippines |  |\n| --- | --- |\n| Received May 12, 2025; Revised June 18, 2025; Accepted June 30, 2025 Handling Editor: Francis S. Nahm\u003Cbr>Correspondence: Jose Eric Mella Lacsa\u003Cbr>Department of Theology and Religious Education, De La Salle University, Taft Avenue, Manila 1007, Philippines Tel: +09162266952, [E-mail:](E-mail: jose.eric.lacsa@dlsu.edu.ph)[ jose.eric.lacsa@dlsu.edu.ph](E-mail: jose.eric.lacsa@dlsu.edu.ph) |  |\n| TO THE EDITOR\u003Cbr>Chronic pain is more than a lingering sensation; it is a reflection of profound neuroplastic changes within the brain. In Jaffal [1]'s recent review article, \"Neuroplasticity in chronic pain: insights into diagnosis and treatment,\"he compellingly outlines how persistent pain induces structural and functional remodeling of the brain. These changes include reductions in gray matter volume, altered connectivity, and the reorganization of critical networks such as the central executive network, default mode network, and salience network. Such changes impair sensory and emotional processing and contribute to the reinforcement and persistence of pain over time.\u003Cbr>This emerging recognition of chronic pain as a disease of the brain has profound implications for both global and local contexts. Worldwide, chronic pain affects more than 1.5 billion people, placing a significant burden on individuals, families, and healthcare systems [2] . Yet, in many low-and middle-income countries, including the Philippines, chronic pain remains underdiagnosed and inadequately treated. Cultural beliefs, stigma, and limited access to specialized care often compel individuals to normalize or ignore their pain until it becomes deeply entrenched and debilitating [3] .\u003Cbr>Dr. Jaffal’s insights compel us to rethink (our approach | to) pain management. Neuroimaging studies now show that chronic pain physically alters key brain regions such as the anterior cingulate cortex, insula, prefrontal cortex, thalamus, and hippocampus. These findings represent a paradigm shift: pain is not merely a symptom to be managed but a neurological condition to be diagnosed and treated at its roots [4] . Importantly, structural and functional brain changes offer a valuable opportunity to develop diagnostic markers and targeted therapies grounded in the principles of neuroplasticity.\u003Cbr>Incorporating this knowledge into Philippine healthcare, however, presents both challenges and opportunities. Advanced neuroimaging technologies remain limited,(particularly) outside major urban centers [5] . Nonetheless, practical strategies such as upskilling healthcare workers on the neurobiology of pain, promoting early intervention, and integrating psychosocial therapies can yield meaningful improvements. Community health programs that emphasize cognitive behavioral therapy, mindfulness, and graded physical activity—all aimed at reshaping maladaptive neural circuits—could offer low-cost yet effective solutions.\u003Cbr>Globally, as well as locally, the next critical step is research. As Dr. Jaffal rightly notes, neuroplasticity offers a promising framework for understanding and treating chronic pain. Nevertheless, further studies are needed to |\n\nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by-nc/4.0](licenses/by-nc/4.0)), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nCopyright © The Korean Pai","cbCaikfV0ZCapQHo","https://ap.wps.com/l/cbCaikfV0ZCapQHo","pdf",291967,"English","# Letter to the Editor\n## Chronic pain as neuroplastic brain disease\n## Global burden and underdiagnosis in low- and middle-income countries\n## Neuroimaging findings and clinical opportunities\n## Challenges, practical strategies, and future research\n## Data availability, acknowledgments, conflict of interest, funding, author contributions","[{\"question\":\"Why does the letter argue that chronic pain is more than a symptom?\",\"answer\":\"It states that persistent pain mirrors neuroplastic changes in the brain, including structural and functional remodeling that affects sensory and emotional processing.\"},{\"question\":\"What does the letter say about chronic pain in low- and middle-income countries?\",\"answer\":\"It notes that chronic pain is often underdiagnosed and inadequately treated due to factors such as stigma, cultural beliefs, and limited access to specialized care.\"},{\"question\":\"How does the letter propose improving diagnosis and treatment?\",\"answer\":\"It emphasizes using neuroimaging-informed concepts to develop diagnostic markers and targeted therapies, combined with early intervention, training healthcare workers, and community psychosocial approaches like cognitive behavioral therapy, mindfulness, and graded activity.\"}]","Chronic pain as a brain disease: bridging neuroscience and global health - Letter to the Editor | PDF",1790665462]