PAIN CARE

Using Your Mind to Control Pain

By Richard Asa @RickAsa
 | 
February 23, 2017

Blocking your pain can be as simple as imagining something pleasant, counting silently to divert your mind, or focusing on a non-painful part of your body. 

Researchers are finding that your brain has the ability to change its structure, or apply a form of neuroplasticity in reaction to the sensation of pain. 

There’s the story of Michael Moskowitz, MD, an assistant clinical professor of anesthesiology and pain medicine at the University of California, Davis, who fell and badly broke his thigh bone. While waiting for an ambulance he felt no pain. 

He later realized that he was experiencing a “medical phenomenon” he has taught his own students for years but had never gone through himself.

 

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“My brain simply shut off the pain,” Moskowitz says in “The Brain’s way of Healing,” a book by Norman Doidge, MD, that explores the neuroplasticity of the brain and its ability to block pain. Doidge is a Canadian-born psychiatrist and best-selling author. 

“I had first-hand experience that the brain, all on its own, can eliminate pain, just as I, a conventional pain specialist, had tried to do for patients by using drugs, injections, and electrical stimulation,” Moskowitz says in the book. 

The brain can shut pain off because the function of acute pain is to alert us to danger. So, as long as Moskowitz didn't move, he was in no danger, as far as his brain could tell, Doidge writes. 

“We now understand that the pain perception system is spread through the brain and spinal cord, too, and the brain controls how much we feel. When pain messages are sent from damaged tissue, these messages ascend to the brain only if the brain gives them 'permission,'” adds Doidge. 

This means there are active control systems in your brain. It isn’t just the passive recipient of pain signals you are helpless to influence. 

There was the friend of Mary Heinricher, PhD, who ran around trying to get things out of his barn as a wildfire approached his house in rural Montana. He hadn’t noticed that he had significant burns on his arms and legs, and it took several hours before he realized he needed to go to the hospital. 

Her friend’s pain inhibiting system had blocked the pain signal during a time of fight or flight. Heinricher is a professor of neurological surgery and behavioral science at the Oregon Health and Science University. 

Researchers have used functional magnetic resonance imaging to allow chronic pain patients to "visualize" pain, writes rheumatologist, Mark Borigini, MD, in Psychology Today. “These images allow a patient to actively participate in manipulating what has heretofore been an amorphous concept. The chronic pain patient becomes empowered, whether it be through yoga, biofeedback, or meditation.” 

Blocking pain, he writes, can be as simple as imagining something pleasant, counting silently to divert your mind from the pain, focusing on a non-painful part of your body, or traveling back in time when you were pain free. 

“These tasks seem silly to some; or, at best, self-evident,” he writes. “But for some chronic pain patients they do help. A professional may be needed during the learning process; and it may take practice before these techniques have an impact on the chronic pain patient. You know you are good when you can reduce pain and increase relaxation with a few deep breaths. The sense of control that accompanies such mastery in and of itself can be responsible for a significant reduction in chronic pain.”

 

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Vidyamala Birch of Manchester, England, runs a thriving practice teaching students mindfulness to address their pain. She has chronic pain herself, from two spinal injuries. 

But through mindfulness, the act of being in the moment and acknowledging thoughts and feelings, she and hundreds of students have taken control of their pain.

"The intuitive response is to turn away from it and try and get on with life in spite of your pain," she told the BBC. "With mindfulness, what we do is we turn towards it, to investigate what is actually happening in each moment.... We have adapted the 'mindful movement' so that the primary emphasis is on being aware as you move, rather than how far you can move," she says. "You go to open a door, you've got discomfort, you tense against that movement and your pain will get worse."

Different approaches to mindfulness and meditation have been applied to pain control, but all acknowledge the connection between the body and the mind – and the ability of the mind to control what pain the body is generating. 

To help reduce the overuse of opioid painkillers, now considered a serious problem in the U.S., an intervention called Mindfulness-Oriented Recovery Enhancement (MORE) led to a 63 percent reduction in opioid misuse. 

“Mental interventions can address physical problems, like pain, on both psychological and biological levels because the mind and body are interconnected,” said study author Eric Garland, an associate professor of social work at the University of Utah. “Anything that happens in the brain happens in the body — so by changing brain functioning, you alter the functioning of the body.”

 

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Updated:

February 23, 2017

Reviewed By:

Janet O’Dell, RN