Treatment - Manage chronic pain with mind and body techniques

Source: Mayo Clinic Women's Health Source - April 1997

Can you think your migraines away? Can you wish away the aches in your joints or the twinges in your shoulder? Yes - at least to a certain extent, according to the latest findings from pain research.

What you think, feel and even how you were raised can determine how you experience the physical sensation of pain. That's why pain specialists are now combining traditional physical therapy and pain medication; with less mainstream techniques such as medication, guided imagery, deep breathing and progressive muscle relaxation. This combination of therapies strikes pain where is resides – in both your body and your mind.

The power of thought

Research started more than 30 years ago has uncovered new alternatives for managing pain. In 1965, two scientists proposed the central nervous system – which transmits pain signals from your nerve endings to your brain – has "gates" that open and close to allow pain messages to either reach your brain or be blocked. The theory has gained wide acceptance.

More recent research suggests these psychological factors can determine how your brain receives pain messages.

Mood - Your attitude and mindset may explain why the headache you get the day your boss gives you a raise doesn't hurt as much as the once you get the day your car breaks down on the expressway.

Personality – Your thoughts and feelings color your perception of pain. Your tense or angry reaction to pain can cause additional stress, leading to headaches, muscle spasm and jaw pain.

Fears – Believing your pain is beyond your control can make is seem worse. If you're worried that your joint pain will keep you up all night, it probably will.

Energy level – Your arthritis may act up more after a long work day than when you're taking a relaxing vacation.

How you were raised – If your parents were stoic about pain, you're more likely to brush it off. Your pain may seem worse if your parents treated every cut and scrape as catastrophic.

Using relaxation techniques to control pain

Relaxation techniques, used in conjunction with pain medications and physical therapy, can diminish and, in some cases, eliminate your pain.

Meditation – Although it's one of the most effective relaxation techniques, meditation requires diligent practice. The most common approach is transcendental meditation, in which you use a repeated word or sound, called a mantra, to keep you mind free of distracting thoughts for 20 minutes at a time. Eventually you achieve a state of calm and control. In a type of meditation called "mindfulness," you focus on your breathing and pay attention to your intrusive thoughts – even pain– but remain nonjudgmental. You're aware of your pain, but are emotionally detached from it. Eventually it becomes less noticeable. Meditation is usually a solitary pursuit that requires two 20-minute sessions daily.

Guided imagery – This technique involves using your mind to place yourself in a tranquil setting, walking on the beach or resting under a tree. When you're fully relaxed, the next step is to send yourself positive messages about your pain. This is often easier to do with guided imagery tapes available in bookstores.

Deep breathing - - Take a deep breath, fill your lungs with air for a count of about four seconds, then exhale for four. Repeat to release muscle tension and lower your blood pressure. You can use deep breathing anytime, anywhere.

Progressive muscle relaxation - - This is one of the easiest techniques to learn. All you need is a quiet, comfortable place to lie down. Then you make a tight fist and hold it for five seconds. After noting the tense sensation, release your fist and feel the tension leave. Repeat the tense-release technique on the rest of your muscles to relax your whole self. Because this technique may focus too much on painful joints and muscles, it may not be appropriate if you have a joint or muscle disorder.

For more information:

Full Catastrophe Living by J. Kabat-Zinn, Ph.D., 1990 Delta, Bantam-Doubleday.

The Relaxation and Stress Reduction Workbook by M. Davis, Ph.D., E. Eshelman, M.S.W., and M. McKay, Ph.D., 1988, New Harbinger Publications, Inc.

Mastering Stress: A Lifestyle Approach by D.H. Barlow, Ph.D., and R.M. Rapee, Ph.D., 1991, American Health Publishing Co.

PAIN REMOVAL IMAGERY

designed by Crystal Hawk

(This is an imagery with which you can create something positive for yourself—to use any time you need it and as often as you need it. This imagery works effectively to reduce or eliminate all pain and discomfort - physical, emotional, mental or spiritual. You may want to repeat this imagery exercise several times.) Get into a comfortable position, either sitting or lying down…take off your shoes…loosen your belt…remove your glasses* …and pay attention to your breathing…don't change your breathing…just pay attention…watch your breath as it comes into your body and leaves your body…and follow its flow…listen to any sounds in the room…and silently name them - people walking, birds, traffic…and tell yourself that any sounds you hear will allow you to go deeper and deeper into a state of relaxation. Now allow yourself to focus in on your pain (or tension, or emotion)…and for a few moments allow yourself to feel it in its fullness…then…without forcing…allow a shape to emerge which represents for you…for today…this pain…don't create it…just allow it to emerge…and notice the shape…now allow the shape to have a color…don't give it a color…just allow it to happen…and notice if the shape has a texture…is it flat…or textured…shiny…or woven…and also notice if it has a smell…or sound… Now allow the shape to shrink…don't direct it…just allow it to shrink…smaller and smaller…until it's the size of the head of a pin…and then, without forcing, just allow it to leave your body through any opening it chooses…or, create an opening for it…and allow it to flow out of you and into the larger open spaces around you…rising up into the room you are in and allow it to leave that room from a magical opening on the ceiling…and then allowing your shape to drift up and out into the sky above…and take as much time as you need to allow this to happen… Now, slowly coming back to the room…first by feeling your physical body and how you are connected to the chair you're sitting on…and noticing how your feet are connected to the floor (or if lying down, become aware of how your body is coming in contact with whatever you are lying on)…and before opening your eyes, go inside and check out what changes you've made. *when conditions are ideal, otherwise just do it! YOU CANNOT OVERDOSE ON THIS NON-INVASIVE HEALING MODALITY PRACTICE***PRACTICE***PRACTICE***PRACTICE***PRACTICE please feel free to copy and/or distribute or teach this imagery We thank the people at The North American Chronic Pain Association of Canada for this. It was featured in their NACPAC Track newsletter for Winter 1996.