Using Your Brain To Control Pain

Relaxation, meditation, positive thinking, and other mind-body techniques can help reduce your need for pain medication.pain 

Drugs are very good at getting rid of pain, but they often have unpleasant, and even serious, side effects when used for a long time.  If you have backache, fibromyalgia, arthritis, or other chronic pain that interferes with your daily life, you may be looking for a way to relieve discomfort that doesn’t involve drugs. Some age-old techniques—including meditation and yoga—as well as newer variations may help reduce your need for pain medication.

Research suggests that because pain involves both brain and the body, mind-body therapies may have the capacity to alleviate pain by changing the way you perceive it.  How you feel pain is influenced by your genetic makeup, emotions, personality, and lifestyle.  It’s also influenced by past experience.  If you’ve been in pain for a while, your brain may have rewired itself to perceive pain signals even after the signals aren’t being sent anymore.

Researchers recommend that it may be best to learn several of these techniques so that you can settle on the ones that work best for you.  Think of these techniques as similar to flavors in an ice cream store.  Depending on your mood, you might want a different flavor of ice cream—or a different technique.  Practicing a combination of mind-body skills that calm the brain increases the effectiveness of the pain relief.

The following techniques can help you take your mind off the pain and may help to override established pain signals.

Deep breathing.  This is central to all the techniques, so deep breathing is the one to learn first. Inhale deeply, hold for a few seconds, and exhale.  To help you focus, you can use a word or phrase to guide you.  For example, you may want to breathe in “peace” and breathe out “tension.”  There are also several apps for smartphones and tablets that use sound and images to help you maintain breathing rhythms.

 Eliciting the relaxation response.  An antidote to the stress response, which pumps up heart rate and puts the body’s systems on high alert, the relaxation response turns down your body’s reactions.  After closing your eyes and relaxing all your muscles, concentrate on deep breathing.  When thoughts break through, say “refresh,” and return to the breathing repetition.  Continue doing this for 10 to 20 minutes.  Afterward, sit quietly for a minute or two while your thoughts return.  Then open your eyes and sit quietly for another minute.

Meditation with guided imagery.  Begin deep breathing, paying attention to each breath.  Then listen to calming music or imagine being in a restful environment.  If you find your mind wandering, say “refresh,” and call the image back into focus.

Mindfulness.  Pick any activity you enjoy—reading poetry, walking in nature, gardening, or cooking—and become fully immersed in it.  Notice every detail of what you are doing and how your senses and emotions are responding.  Practice bringing mindfulness to all aspects of your life.

Yoga and tai chi.  These mind-body exercises incorporate breath control, meditation, and movements to stretch and strengthen muscles.  Videos and apps can help you get started.  If you enroll in a yoga or tai chi class at a gym or health club, your health insurance may subsidize the cost.

Positive thinking.  When we’re ill, we often tend to become fixated on what we aren’t able to do.  Retraining your focus on what you can do instead of what you can’t will give you a more accurate view of yourself and the world at large.  Keep a journal in which you list all the things you are thankful for each day.  We may have limitations, but that doesn’t mean we aren’t still whole human beings.

Neurofeedback Therapy for Pain Management

chronicpainPain is a subjective feeling that can be influenced by sensory, affective, and cognitive factors. Chronic pain can have a widespread impact on overall brain function, and both cognitive and psychological factors play key roles in the development and management of pain.

Patients with long-term pain often have structural and emotional impairments associated with cortical regions of the brain that are linked not only to pain itself, but also to other disorders that develop in association with chronic pain, for example, depression, anxiety and sleep disturbances. Patients with chronic pain often receive long-term pharmacological treatment; but there are a number of drawbacks mainly due to the undesirable side-effects that often arise with a continued use of analgesic drugs. There is a constant search for better pain management options, including non-pharmacological approaches. In the last decades, neurofeedback has been gaining ground as a potentially successful option.

is a form of biofeedback. Biofeedback was born from the observation that one can control and manipulate certain bodily functions associated with the autonomic nervous system by being aware of them. Using instruments that measure physiological activity such as heartbeat, breathing, muscle activity, or skin temperature, a subject can receive fast and accurate information regarding those functions, and in turn, and with adequate training, manipulate those functions which can lead to changes in thinking, emotions, and behavior. Over time, these changes can become long-lasting, enduring even without the continued use of monitorization instruments.

Neurofeedback, is simply biofeedback techniques that are applied to the brain. Neurofeedback, also known as EEG-biofeedback, uses electroencephalograms (EEG) to monitor brain waves, producing a signal that can be used as feedback to learn how to self-regulate brain functions. Recently, other monitoring techniques have begun to be applied, namely functional magnetic resonance imaging (fMRI) biofeedback.

For decades, it has been known that with adequate training, brain waves can be controlled. Intellectual activity induces fluctuations in the brain’s bioelectric activity that can translate into neurophysiological changes. By understanding the association between the bioelectric activity of different brain areas and the associated cognitive, emotional, behavioral, or even pathological processes, neurofeedback can allow the modification of those specific processes.

Neurofeedback has proven useful in inducing relaxation and attention, in enhancing creativity, and as a therapy for a number of conditions – sleep disorders, epilepsy, depression, anxiety, language processing, or enhancement of perception and learning. Another context in which neurofeedback has shown interesting effects is chronic pain.

The psychological factors that influence pain perception have the ability to modify our body’s biochemical processes. Thoughts can have a direct impact on these processes and potentially produce analgesia. In fact, there is evidence indicating that cognitive control of pain can have a direct effect on opiod activity, stimulating the production of endorphins.

Another mechanism through which neurofeedback can modulate pain is the regulation of the emotional component of pain. The frontal cortex is associated with the feeling of unpleasantness associated with pain. Neurofeedback training applied to this region of the brain has been found to be able to affect levels of pain in patients with acute and chronic pain syndromes, leading to an increased pain tolerance.

Chronic pain can also induce changes in the functional organization of the brain. Neurofeedback can allow the control of pain by altering the connectivity between brain regions, thereby inducing long-lasting changes in neuronal networks that can counterbalance the changes induced by chronic pain.

Indeed, clinical data has demonstrated the effectiveness of neurofeedback therapy in a number of chronic pain conditions: it can decrease headache intensity, being particularly effective in children and adolescents, as well as migraine and pain associated with fibromyalgia. Neurofeedback can also be effective in post-operative pain as well as cancer pain.

During the last decades, neurofeedback training approaches and protocols have been steadily improving, along with its successful effects. As new methods arise, it is likely that neurofeedback can gain awareness and importance as a non-pharmacological therapy for a multitude of disorders. fMRI imaging, for example, can be a great upgrade for this therapy by allowing the detection of brain areas affected by chronic pain, and consequently allowing a more targeted intervention.

The take-away is: If one can learn to directly control the activation of specific brain regions, one can potentially be able to control neurophysiological mechanisms that may help in the treatment of other diseases.