| Posted on Mon, Feb. 05, 2007 In pain? Use your brain Mind-body connection is key to techniques for controlling discomfort LAURA BEIL Dallas Morning News Since human misery can't be measured with an X-ray or blood test, the only true gauge of pain lies inside a person's own mind. One approach to pain management, experts say, is to transform the brain from a simple messenger for pain into its master. A generation ago, the American public largely viewed mental methods of pain control with the same seriousness as a Vulcan mind meld. Since then, acceptance of alternative medicine has soared, with pain sufferers leading the way. The popularity is partly driven by the sheer numbers of desperate people. One 2003 study suggested that 13 percent of the workforce loses productivity from headaches, back pain, arthritis and other common painful conditions. Many of the nation's 50 million or so pain patients often become disappointed with conventional medicine, and with good reason. One expert recently wrote in the journal Annals of Internal Medicine that "the history of treatments for back and neck pain is generally one of small increments in benefit." To gain more relief, people often search inward, to relaxation, stress reduction, meditation, yoga, biofeedback and other approaches that stem from the intersection of mind and body. "Pain is not just pain. Pain is a lot of different things," says John Astin, a researcher at California Pacific Medical Center in San Francisco. "Our reaction to pain is a big determinant of how much suffering we end up having." Tension as a trigger This does not mean pain is imaginary or self-inflicted. This means the anticipation of pain, the dread of it, the stress and anger of it, can influence the amount of anguish.The brain itself, while not able to will away hurt, may restore a sense of control that can become lost. This alone diminishes stress. "Pain causes stress, and stress causes pain," says Dr. James Dillard of Columbia University Medical Center. A conventional doctor with training in chiropractic and acupuncture, Dillard specializes in blending traditional pain treatments with alternative therapies. Mind-body therapies are generally routes to relaxation -- to, as Dillard says, "stop wearing your shoulders as ear muffs." Tension exacerbates pain, or even triggers it. He tells of one recent patient, a college student with chronic, unexplained headaches: "He was holding his neck like a 4-by-4." With treatment from the mind, "you're not talking about a pill that you can easily camouflage," Astin says. "It makes it more challenging to control for placebo effects." Also, many approaches are often used together, making it difficult to tease out the benefit of any one component. Yoga, relaxation Still, a growing body of research supports the idea that the mind can be an ally in pain control. Some examples: A 2000 review of 20 studies of mind-body therapy for low back pain, published in the journal Spine, found "strong evidence" that mind-body therapies could reduce the intensity of the pain. An overview published last year from experts at Ohio University also drew favorable conclusions for biofeedback, stress management and relaxation for migraine headaches. And a study published last year in the Annals of Internal Medicine found that people with chronic low back pain who regularly practiced gentle yoga experienced greater relief of symptoms than those who subscribed to aerobic and strength exercises or were given a copy of "The Back Pain Helpbook." There is also evidence that the mind can have effects beyond the psychological. For instance, research published in 2003 in the journal Psychosomatic Medicine reported that meditation produced measurable changes in the brain's electrical activity and the body's immune system. If nothing else, experts say, relaxation will do little harm. Astin teaches a kind of meditation that encourages patients to call a truce with their bodies. "There is a programming in the body to move away from pain," he says. This can make the body tense. When people stop their private war, he says, they become more relaxed and feel they are not at the mercy of their own bodies. He points out that you can try this at home: Next time you undergo something painful (like a shot or a dental procedure), try relaxing and just allowing it to happen without recoil. Methods That Might Help • Relaxation techniques: Practices that seek to reduce muscular tension or elicit the opposite of arousal. • Meditation: The two most extensively researched forms of meditation are transcendental meditation and mindfulness meditation. In transcendental meditation, a person concentrates on a word or phrase as a way of quieting internal mental dialogue. In mindfulness meditation, a person attends to sensations and emotions as they arise. • Guided imagery: Guided imagery involves using mental images as a route to relaxation or a sense of well-being. • Biofeedback: Biofeedback uses devices that help amplify a physical process, such as blood pressure or muscle tension, that normally can't be detected. An example would be hearing a tone that changes as muscles relax. SOURCE: Journal of the American Board of Family Medicine |
|||||