Chronic Pain Management Actually Starts In The Mind — Here’s Why

//Chronic Pain Management Actually Starts In The Mind — Here’s Why

Chronic Pain Management Actually Starts In The Mind — Here’s Why

The American Psychological Association notes that chronic pain can negatively affect a person’s life. This can lead to depression, anxiety, and other mental disorders. Because of this, they suggest that mental practices and support are an important component to chronic pain management. The following video discusses these suggestions. Then we’ll discuss how mental practices, like yoga, meditation, and visualization, can help change your brain when it comes to chronic pain.

How does chronic pain change the brain?

Chronic pain changes the brain in numerous ways. First, it changes the amount of gray matter present. Gray matter is found in the brain and spinal cord, and is an important part of the nervous system. It contains nerve cells and related parts. Researchers have also found reduced gray matter in patients living with fibromyalgia, according to APS. Scientists believe the decline might be related to disruptions in the neurotransmitter dopamine, linked to pleasure and reward.

The reduced gray matter not only affects pain, but also anxiety and depression. Dr. M. Catherine Bushnell with the National Center for Complementary and Integrative Health (NCCIH) told a meeting of the APS:

“Imaging studies in multiple types of chronic pain patients show their brains differ from healthy control subjects (by having less gray matter)… Studies of people with depression show they also have reduced gray matter.”

Other changes in the brain include where the pain is processed. Research published in the journal Brain found that while acute pain is processed in areas meant for processing pain, chronic pain moves to areas more involved in emotion. Chronic pain is an emotional experience as well as a physical one, and the link in brain chemistry highlights that connection.

Visualization can help with chronic pain management 

Visualization, the process of imagining specific scenes or imagery, is effective for helping people manage pain, according to a study conducted by the European Society of Cardiology. The mind and body are intimately connected, with thoughts influencing biology and biology influencing thoughts. For example, undesirable emotional states like stress and depression have been identified as causes of a weakened immune system. This can increase the risk of the cold or flu, according to

The interplay between the body and mind plays a major role in chronic pain management. Before advances in modern medicine, doctors believed that emotions were significant causes of disease. Family physicians focused heavily on lifestyle factors that were believed to contribute to pain and other health conditions. As medicine became more advanced, the focus shifted to biological causes of disease. The emotional connection was lost, according to the National Institutes of Health.

Now, the pendulum is swinging towards center, with modern medicine and all its benefits readily available while other interventions aimed at calming emotions are becoming more prevalent. Research is increasingly quantifying the age-old idea that emotions such as stress and sadness significantly influence states of health or disease, particularly in chronic pain.

Chronic Pain Management Actually Starts In The Mind -- Here's Why |

Reduced stress through visualization 

To investigate this increased awareness of the mind’s impact on the experience of post-operative pain, researchers in Denmark asked patients to visualize a place they felt safe, such as the beach, woods, or a vacation home. Lead study author Marianne Wetendorff Norgaard describes:

“When the patient expresses pain, the nurse helps the patient visualize an alternative scenario to the invasive procedure. For example, if the patient says ‘my chest is burning,’ the nurse may say ‘imagine that it’s a cold day and there is ice on your chest.’”

Researchers compared 76 patients who used visualization techniques to 71 patients in a control group. Pain and anxiety levels were recorded every 15 minutes and after specific experiences of pain. Patients in the visualization group reported less pain and requested fewer painkillers. Norgaard adds:

“Patients told us that visualizing their own safe place during the procedure made them feel involved and helped them cope with pain and anxiety.”

Researchers said visualization may be used to calm nerves, but could also reduce the instances where general anesthesia is used for certain procedures.

How to use visualization techniques

A good way to learn this technique is to start with guided visualizations like this free one that’s intended to reduce muscle tension and reduce chronic pain. Allowing the mind to relax can take practice, so don’t worry if you have a hard time letting go. Have patience and enjoy the process.

While listening to the visualization, lay down or sit cross-legged with your eyes closed. Consider darkening the room or perhaps lighting a candle. Get comfortable, but make sure to stay awake. Falling asleep will prevent you from enjoying the benefits of visualization.

Staying awake is very important to note because when visualizing, you’re creating new mental pathways. Falling asleep while visualizing begins to create pathways in the brain linking the guided imagery and sleep, increasing the risk that you will continue to fall asleep every time you practice the technique.

Many times, the visualizations will involve envisioning a peaceful place such as the ocean or the forest. You may be asked to picture light emanating from various places in the body. These practices may be very different from those that you’re used to, but try to keep an open mind and stay committed to the technique.

The positive effects may not be immediate, but maintain the effort to see if this practice is helpful for your chronic pain management.

Developing a personal visualization practice

Once you learn the basics of visualization, you may customize the techniques to work for you. Make sure you’re in a space where you feel comfortable and won’t be interrupted. Silence makes a fine background, but so does light, relaxing music.

Let’s consider a patient with back pain. You might begin the visualization by lying down, and bringing awareness to each part of the body. Starting at the feet, notice the sensations there, before moving to the calves, knees, thighs, and pelvis. Release tension in each area of the body before moving upwards to the abdomen, chest, neck, and head.

After relaxing the entire body, bring awareness to the area with pain. Imagine a bright white light emanating from this area, healing whatever is causing you pain.

Alternatively, you might try an active visualization where you imagine yourself fully functioning and enjoying a favorite sport or activity, pain free. Visualize what it looks like to be healthy, happy, and vibrant. The body will ideally respond in kind, bridging the gap between the body and the mind for chronic pain management.

Chronic Pain Management Actually Starts In The Mind -- Here's Why |

What happens if negative images arise?

Sometimes during visualization, negative emotions or images can arise despite a person’s best efforts. These negative images can arise from parts of ourselves that resist the healing process, and typically result from fear, according to Deepak Chopra. Chopra says:

“You can’t just try to replace these negative images with positive ones, because the fear will throw up an endless stream of images and the positive images are not coming from a deeper level than the fear.”

Chopra recommends addressing the underlying fear so that it stops interfering with efforts to heal. Instead of getting lost in the negative image, notice the fear underlying it. Where does that fear come from? Where in the body? What does it feel like? Try to avoid judgment and instead notice the sensations that arise.

Feeling the fear is actually a way to heal it. You don’t have to understand it, just simply feel it. Sometimes thoughts or epiphanies may arise surrounding the fear as you feel it, providing greater insight into why you feel that fear or other types of resistance. When you feel ready, return to the positive visualizations.

Often, it takes repeated effort to heal fear or other uncomfortable emotions since these can be buried deep inside the psyche. Treat yourself with compassion, avoiding judgment, and patiently feel whatever comes up so you can continue positive, healing visualizations.

Yoga can also help change the brain

As noted, chronic pain is known to cause lasting changes in the way the brain functions. These changes are one reason why researchers speculate that chronic pain is so difficult to treat. There isn’t yet a good medical intervention for reversing the changes.

Yoga, however, also causes lasting shifts in brain functioning, and a study from the American Pain Society (APS) has revealed how the alterations may prevent or even reverse chronic pain pathways. The findings are huge because they underscore the ability of holistic treatments to help people with chronic pain management.

How does yoga change the brain?

Yoga changes the brain in the exact opposite way that chronic pain does, according to APS. Bushnell says that brain studies of long-time yoga practitioners show they have more gray matter than control subjects. She adds:

“Some gray matter increases in yogis correspond to duration of yoga practice, which suggests there is a causative link between yoga and gray matter increases.”

The increases in gray matter help to heighten a person’s pain tolerance, making them less susceptible to discomfort. The changes also help to ward off depression and anxiety, which commonly affect chronic pain patients.

The hippocampus, which helps manage the stress response, is also frequently enlarged in yogis, according to researchers at NCCIH. The yogis studied dedicated about 70% of their practice to the physical postures, 20% to meditation, and 10% to breath work. While many people think of the physical postures when it comes to yoga, meditation and breathing techniques, known as pranayama, are important parts of the practice.

And while all types of exercise have a beneficial effect on mood, anxiety levels, and experiences of pain, research published in the Journal of Alternative and Complementary Medicine found that the benefits of yoga are superior to some other types of fitness.

Researchers compared yoga to walking. They found that yoga was more effective in reducing feelings of anxiety and improving overall mood. While many brain scan studies have investigated the effects of yoga on seasoned practitioners, the fitness evaluation was completed on novice yogis. To qualify for the study, participants couldn’t have practiced yoga at any time in the previous three months. Study subjects either walked or practiced yoga three times each week for 60 minutes at a time, for 12 weeks.

Chronic Pain Management Actually Starts In The Mind -- Here's Why |

Meditation benefits the brain in significant ways

Scientists have also been busy examining the brains of experienced meditators. Meditation is a part of yoga, but exists in many other practices, too. The many types of meditation include Buddhist methods and more modern variations, such as Mindfulness-Based Stress Reduction. However all the practices emphasize the same core principle of increasing awareness of the present moment.

People have been meditating for centuries, and science is now showing how the practice changes people’s brains in beneficial ways. The changes become more pronounced the longer people practice meditation, according to Psychology Today.

Without meditating, people are more likely to immediately perceive potentially negative stimuli like pain or anxiety as dangerous to their safety, reports Psychology Today. That’s because the area called the medial prefrontal cortex, which processes information related to us as individuals, is most active. Psychiatrist Dr. Rebecca Gladding calls this section the “me center.” When people rely too much on the me center, they get fixated on negative things in life: the bad things that have happened, what other people think, and fears about the future.

When people begin to meditate, however, this changes. Over time, meditators stop processing stimuli through the lens of “what is wrong with me?” Instead, meditators are more likely to look at things objectively, with a greater ability to analyze stimuli before deciding whether or not it’s a threat. In addition to strengthening this logical center of the brain, meditating strengthens a person’s ability to practice empathy and compassion. When we feel compassionate towards ourselves, we’re better able to feel that compassion towards others.

To enjoy these benefits for chronic pain management, Gladding says that practicing daily is important. Sitting for 15 minutes each day is a good goal. But even if you start with one minute, that is a perfect way to begin.

Changing your mind about chronic pain management

Getting started with any of these practices is as easy as finding a few quiet minutes and some space. Our posts on these subjects give more information about how you can incorporate these mind-body practices into your chronic pain management.

Have you tried any mind-body practices for chronic pain management? Did they help? 


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By | 2016-12-01T13:29:44+00:00 December 14th, 2016|Tags: |0 Comments

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