The Mind-Body Approach to Pain Management

March 06, 2020

The Mind-Body Approach to Pain Management

What do monks and analgesics have in common?

You may not run to a zenned out man in a robe for a throbbing back, but he can teach you a thing or two about  managing a disability that affects over 100 million Americans per year. 

 

The deal with chronic pain

1 in 10 Americans experience some form of chronic pain in their body. 

How do you know when the discomfort you feel is considered chronic? Pain is considered chronic when it bugs you for 12 weeks or longer despite medication or treatment.

The first line of defense against pain are analgesics, and when it’s a little worse - prescription opioid analgesics. Taking analgesics may seem harmless for a tension headache or when one is in post-op recovery, but medicating for chronic pain can pose a threat to the bank and the body. 

The price of chronic pain adds up to a hefty sum of 70 to 100 billion dollars per year in treatment costs and lost productivity. It’s obvious that long-term support for these medications cost an arm and a leg, and the threat of drug tolerance and addiction is high. 

It’s not a win-win situation when you’re dependent on pain pills to ease your agony. Luckily, more and more scientific evidence points towards mind-body practices as an effective approach to pain management. 

 

The Mind-Body Connection

Over the years, studies have emerged detailing the effectivity of mindfulness meditationcognitive behavioral therapy, and relaxation techniques as an alternative approach to pain management. Physicians are adapting to the multidisciplinary and biopsychosocial approach to care. 

The biopsychosocial model of pain posits that no biological system exists in isolation. It acknowledges the physiological, psychological, and social factors unique to each person as dynamic elements that affect a person’s experience of pain.

The mind-body connection is irrefutable. Constant stress and worry lead to muscle tension, stomach problems, and even cardiovascular diseases.

Our mind and body respond to each other in ways more powerful than we can imagine. Patients of fibromyalgia, cancer, or chronic conditions have shown a pattern of falling into depression because of their illness. The constant worry and rumination of their condition can lead to helplessness and anxiety. 

In the same vein, patients with depression can develop medical conditions such as heart diseases when not managed. 

So how do you take your power back?


Mind-Body Approach to Pain Management

Pain is a sensory and emotional ordeal which goes beyond skin and bones. It is only fitting that the approach to pain management also goes beyond a pill and a doctor’s visit.

Here we’ve rounded up the different mind-body therapies out there that can help manage chronic pain. 

 

Cognitive Behavioral Therapy

Our brain has “automatic thoughts” in the face of a harmful stimuli. It puts us in a state of stress or anxiety in order to push us to fight or flee. It’s simply looking out for us. 

But can you imagine being in this constant state of panic for an extended period of time?

Patients with chronic pain often fall into pain catastrophizing, a cognitive distortion where the patient becomes extremely negative to the outcomes of his/her condition. It’s these automatic thoughts that run wild, eventually leaving the patient helpless and powerless over the disease. 

Rational Emotive Behavior Therapy, or REBT, is the pioneering form of cognitive behavioral therapy,  which zeroes in on the internal dialogue about the pain that a patient experiences. 

 

The framework for REBT can be dissected into three parts:


A - Activating Event

B - Beliefs

C - Consequence


When a stressful event or a painful episode strikes (activating event), your beliefs dictate whether the consequences becomes negative or positive. 

In the case of chronic pain (activating event), your beliefs about pain and recovery dictate whether your experience is damning or healing. Pain acceptance empowers the patient to face the discomfort and urges the patient to adapt an empowering view of healing.

The goal of Cognitive Behavioral Therapy is to ease the psychological distress associated with pain by reframing your beliefs surrounding your condition. It encourages a problem-solving attitude by empowering the patient to make sense of the pain and take action - mental or physical - to positively impact the situation.


Relaxation Response

When under stress, our bodies activate the sympathetic nervous system, popularly known as the fight or flight response. In this state, our body shoots out adrenaline, which manifests as pupil dilation, increased sweating, increased heart rate, and increased blood pressure.

Your fight or flight response serves you well when a lion is running after you, but being in this state for a prolonged period makes you more vulnerable to cardiovascular diseases, weight gain, and anxiety. 

To counter this, we need to trigger the relaxation response or to activate the parasympathetic nervous system, which conserves energy, slows down the heart rate, and eases muscle tension. 

The relaxation response can be a quick fix when you feel an ache creeping in. 

Here are the many ways you can activate the relaxation response:


Foursquare breathing

The foursquare breathing is a form of deep, abdominal breathing in intervals of four’s: inhale for four counts, hold your breath for four counts, exhale for four counts, exhale for four counts, and hold again for four counts. 

Do this for 10 cycles or until you feel relaxed, or until the pain subsides. 


Hypnosis and Visualization

Hypnosis for pain management relaxes your nervous system to make it less reactive to pain. 

Being in a hypnotic state allows you to focus on relaxation and tunes out the conscious part of your brain that’s yapping about the discomfort you feel. The hypnotic state also makes you highly suggestible to alter your thoughts and immediate responses.

Depending on how your hypnotherapist phrases it, your body can become less reactive and less sensitive to pain. You may also induce yourself to a hypnotic state on your own through guided meditations or visualizations like this one:

 

 

Sleep Hygiene 

The greatest propeller of the relaxation response is proper rest. The sleep-pain cycle is vicious. Pain triggers poor sleep and poor sleep triggers pain. Where can you win?

Prioritizing good bedtime rituals and nightly habits, otherwise known as sleep hygiene, is a must if you have chronic pain.

A few habits to add to your night-time routine can include:

  • Sleep at the same time every night (as much as possible.)
  • Keep an optimal room temperature for sleeping. Not too warm, not too cold.
  • Limit your caffeine intake.
  • Avoid naps throughout the day.
  • Exercise

Mindfulness meditation

Mindfulness meditation is picking up as a complementary therapy in conjunction with medication and other forms of therapy. It has been effective in reducing chronic pain by 57% based on clinical trials, and long-time meditators can reduce their pain up to 90%. 

Pain clinics prescribe mindfulness meditation along with other treatments for patients of cancer, heart disease, fibromyalgia, and chronic fatigue. How does it work?

  • Find a comfortable place to sit. 
  • Close your eyes and breathe naturally without any effort of breathing deeper. 
  • Choose a point of focus such as a mantra or your breath. 
  • Be aware of your breath and the sensations you feel in your body.
  • Your brain will think of other things and your attention will veer away, simply veer it back to your point of focus.
  • Do this for a period of time you’re comfortable with, but 20 minutes to 1 hour is optimal.

Mindfulness meditation refocuses the mind to the present and increases the awareness of one’s surroundings and inner sensations. It sounds counterintuitive, doesn’t it? Why would you focus on the sensation of pain, when you’re in pain?

Focusing your attention on pain allows you to break it down to specific sensations. By dissecting it to granular level, the fear and the suffering subsides. 

It facilitates a state of detached observation, urging the meditator to be aware of the transient sensations in the body.

 

Final Thoughts

Pain is a multi-faceted experience which affects us biologically, socially, and psychologically. We must treat it in the same way. 

Chronic pain is a monster of a disability and greatly decreases the quality of life of its victims. However, medication alone is not enough and it shouldn’t be.

Meditation, Cognitive Behavioral Therapy, and relaxation techniques are all viable methods to help decrease the psychological and physical distress of the patient. In conjunction with non-pharmacological forms of treatment like heat therapy and cold therapy (through the use of gel packsclay packs, and compression wraps), the need and dependence on medication and pills will be significantly lessened, and patients can reclaim their power over pain. 


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