Living With Pain: The Cure Really Could Be in Your Head
One in every four American adults has suffered a daylong bout of pain in the past month, and one in 10 says the pain lasted a year or more, according to a new report issued this week by the Centers for Disease Control and Prevention.
A recent study offers hints on ways to lessen this all-too-common misery: through the mental approaches that people use to deal with their pain and, perhaps in the future, stimulating a newly discovered pain-control brain region.
Feeling that you should and can control uncontrollable pain actually makes it worse, Katja Wiech, a pain researcher at the University of Oxford in England, reported earlier this month in the Journal of Neuroscience. She and her colleagues gave mild electric shocks to the hands of volunteers. The volunteers were told the decision to stop would be made by a person or computer outside the room, and they could do nothing to influence the decision.
At the same time, Wiech gave brain scans to these volunteers. One region on the right side–the anterolateral prefrontal cortex, which helps people cope with anxiety–got more active in people who reported less pain. The truly interesting discovery, though, was that people who felt they should be able to control everything in their lives–call them Type A's, or tightly wound–had less activity in this pain-suppressing region. Not surprisingly, they felt more distress.
"Trying to control things when no control is possible" leads to trouble, Wiech says. A lot of chronic pain conditions simply can't be banished completely, and people who feel they have to make the pain disappear experience the opposite: more distress. It's better, she says, to learn ways of managing the pain instead of battling it. That can include mind-body techniques like relaxation and deep breathing, and using these tools to help accept pain as an unavoidable but manageable part of life.
This notion–that styles of thinking can be good pain medicine–is gaining supporters. What you think really changes what you experience, says Robert Coghill, a neuroscientist at Wake Forest University School of Medicine in Winston-Salem, N.C., who has studied pain perception. Therefore, he adds, sensations of pain can be affected by how you think about it.
In the future, Wiech adds, this brain area may be a ripe target for pain management. Since more activity in that region means less pain, stimulating it through medicine or psychotherapy may give people in pain another tool in their attempt to live happy and productive lives.
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