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Pain Management:
What do you do?
 Pain management is
becoming an important part of life, where according to a Gallup poll,
46% of women and 37% of men experience pain on a daily basis, and 89%
of all adults experience pain at least once a month. Studies in pain
management have also concluded that only one half of those individuals
with pain had visited a doctor in the previous three years to seek
help. Pain is felt when the body has received damage to tissues which
is then perceived by the brain and interpreted as a pain sensation.
This pain sensation may be interpreted as anything from mild to severe
by the brain. However, we all have the ability of reducing our level
of pain through effective pain management.
Pain management and an overview of pain:
Nerve pathways
distributed throughout the body run up through the spine and into the
brain were they are then registered and processed by the somatosensory
cortex. Researchers have now found a much more complex experience than
pain information traveling up nerve pathways and simply being
experienced as pain once they reach the brain. A comprehensive
approach to pain management includes understanding these more complex
phenomena.
If you were to bang
your knee, rubbing it may make it better because the pain receptors
and nerve fibers that transmit pain messages lie close to those
carrying sensations such as pleasant touch and warmth. If "non-pain"
fibers are next to pain carrying fibers which are stimulated, signals
from the pain nerves are blocked before they are consciously
registered. It is believed that the pain blockade occurs because only
one type of sensation can be felt in the same area of the body at the
same time.
Pain Management
frequently utilizes the "gate control" theory of pain, which proposes
that there is a “gate” in the spinal cord which allows only one type
of sensation to pass through at a time. This "competition for
consciousness" between pleasant stimuli and painful stimuli was first
discovered by the physiologists Patrick Wall and Ronald Melzack in the
1960’s. However, more recent research suggests that the “gate effect”
is actually provided by the body's attention system, rather than
strictly related to the sensation of pain.
Pain Management: Attention to pain
In between the two
hemispheres of the brain is an area referred to as the cingulate
cortex which can have the effect of directing attention either
inwards or outwards. If something threatening, exciting or otherwise
significant is going on outside of your body, the cingulate cortex may
switch your attention away from your body and reduce any sensation of
pain. This phenomenon has also been experienced by soldiers in battle
as attention was focused on experiences outside of themselves. In
fact, it has been reported that up to 20% of individuals undergoing
surgery have reported no pain or little pain for hours or days after
their operations.
Chronic pain, such as
that experienced by an individual with sciatica can be very
debilitating, thereby reducing an individual’s ability to cope with
the continuous discomfort. As the individual continues to focus on
the pain sensation, the unpleasant sensation becomes amplified.
Studies have found that as many as 70% of people suffering from
chronic lower back pain do not have injuries which are readily
detectable.
Pain management and endorphins:
Endorphins are
natural painkillers produced by the brain that increases levels of
dopamine (another brain chemical) which then enhance feelings of
well-being. Other brain chemicals are actually used by the brain to
keep the sensation of pain from being registered in the brain.
Oxytocin is a hormone that is produced during labor which doctors
believe has the function of reducing the memory of the pain of
childbirth.
Some information from Making the
Most of Your Brain
Paul Susic MA Licensed Psychologist Ph.D. Candidate
(Health Psychology)
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