In-Sourcing Blog

The pain is in the brain

There are 100 million Americans who suffer from chronic back and neck pain, fibromyalgia symptoms and other forms of pain. The standard treatment: opiods, prescribed at a level of 640 morphine milligram equivalents per person, actually down from 782 milligrams in 2015 but still three times as high in 1999.

Throwing opiods at patients is not the only answer. It addresses the physical component of pain but not the psychogenic or psychological component, which is often dismissed.

Doctors have long known that symptoms of pain can exist in the absence of any physical indication. There’s a famous case study that describes a construction worker who came into the emergency room with a 6-inch nail in his boot. It was so painful, the report says, that the patient had to be sedated with powerful opioids. When the shoe was removed, it turned out the nail had passed clean between the toes. There was no injury.

Pain is fascinating because it sits at the intersection of biology and psychology and reveals how the two are intertwined. There is a relationship between feeling pain and painful feelings. Clearly, our emotions, thoughts, personalities, and learned behaviors often generate feelings we cite as pain.

Revealing studies by renowned orthopedic surgeon Dr. John Sarno point to the mind-body relationship that often is responsible for back pain. In subsequent research the book, “Back in Control,” by Dr. David Hanscom, cites Tension Myoneural Syndrome, a condition where patients suffer real physical symptoms, back pain typically, that are not due to pathological or structural abnormalities but are caused as a result of repressed emotions and psycho-social stress.

Dr. Hanscom describes the “phantom limbs syndrome,” a condition that happens quite frequently: after undergoing amputation of an arm or leg, the patient still reports having pain. The pain is not imaginary; it’s real. It illustrates that the pathway in the brain is still active. Creating new neural connections becomes necessary.

This is where psychological treatment can be helpful. The client can be guided to address his/her stressful feelings and author a new scenario offering a more positive story about the pain they experience.

To that end I use a technique similar to mindfulness meditation. I guide clients to a peaceful, relaxed state, enabling them to become aware of the feelings and sensations associated with the pain occurring in their body. The goal is to detach and observe the pain rather than be consumed by it.

The pain itself is still present but by altering the way the client views it, the amount of suffering associated with it can be eased. By reinterpreting the sensations they feel – imaging a more positive outcome – new pathways in the brain will be created and the pain will decrease.

Psychological treatment is not a cure-all for chronic pain but considering how dangerous and damaging the past decades of treating chronic pain with addicting opioids have been, it’s a worthy option to try.

Facts and references from Internet sites are acknowledged.