To Treat Chronic Pain, Look to the Brain Not Body

This post is taken from a Feature Article by Jessica Hamzelou, “Hurt Blocker:  To treat chronic pain, look to the brain not body” in the 26 November 2016 Issue of the New Scientist.  It is becoming increasingly clear that the root causes of chronic pain will require more than drugs to break the cycle.  The answer lies in how the brain processes pain.

As has been mentioned in previous posts, there are two pathways for pain.  One is from the actual physical injury, whereas there is a second pathway for emotion linked pain.  Recent research indicates that signals from psychological pain networks may take over when the problem becomes chronic.

People can be trained to more directly influence their own brain activity and, potentially, turn down the pain signal.  Neurofeedback can be provided by placing electrodes on participants’ scalps that provide a real-time display of the brain’s electrical activity.  People can learn to alter their brain activity to dial down their pain.  Initial research suggest that neurofeedback might be useful for people with fibromyalgia, as well as those with chronic pain resulting from spinal cord injuries and cancer.

Mindfulness meditation can achieve something similar.  The goal is to achieve a state of ‘detached observation,’ which can help cope with pain.  Studies have suggested that it improves  various types of chronic pain, including fibromyalgia and lower back pain.  A study of 17 people who practiced mindfulness-based stress reduction found that, over time, meditators experienced increases in grey matter in regions of their brains involved in learning, memory, and emotion.  All of these influence pain perception.

The following is taken from a previous healthy memory blog post “Pain and the Second Dart:”
“A great way to return your mind to its “ground state,” neither overexcited nor torpid, simply alert and open, is to become aware of the natural rhythm of the breath as you inhale and exhale.  This is focused attention, prerequisite for the second state of mindfulness meditation:  insight.

Start by focusing on the sensation of the breath entering and leaving you body at the nostrils.  Remember, you are observing your breathing rather than controlling it.  Follow each inhalation and exhalation from the start to the finish.  Notice any slight gap between the in-breath and out-breath.

Don’t be hard on yourself if your mind wanders or you get distracted by a noise.  This is all perfectly normal.  Just remind yourself:  “That’s how the mind works,” and return to the breath.  With repetition, you will get better at noticing when you have lost focus and develop greater mindfulness of the present moment.

Now that you have quieted your mind, allow your attention to broaden.  Whenever a positive or negative feeling arises, make it the focus of your meditation, noticing the bodily sensations associated with it:  perhaps a tightness, the heart beating faster or slower, butterflies in the stomach, relaxed or tensed muscles.  Whatever it is, address the feeling with friendly, objective curiosity.  You could silently label whatever arises in the mind, for example:  “There is anxiety,” “There is calm,: There is joy,” “There is boredom.”   Remember, everything is on the table, nothing is beneath your attention.
If you experience an ache or a pain, stitch or any other kind of discomfort, treat it in exactly the same way.  Turn the spotlight of your attention on the sensation but don’t allow yourself to get caught up in it.  Imagine that on the in-breath you are gently breathing air into the location where the sensation is strongest, then expelling it on the out-breath.  You may notice that when you explore the sensation with friendly curiosity—not trying to change it in any way, neither clinging to it or repressing it—the feeling will start to fade of its own accord.  When it has gone, return your full attention to your breath.

Mindfulness instructors will sometimes talk about “surfing” the wave of an unpleasant sensation such as pain, anxiety, or craving.  Instead of allowing yourself to be overwhelmed by the wave of feeling, you get up on your mental surfboard and ride it.  You experience it fully, but your mind remains detached, dignified, and balanced.  Knowing that the power of even the most fearsome wave eventually dissipates, you ride it out.

If a thought, emotion, or feeling becomes too strong or intrusive, you can always use the breath as a calm refuge, returning you whole attention to the breathing sensations at your nostrils.  Similarly if you feel you can’t cope with a pain such as stiffness in your legs, neck, or back, shift your posture accordingly.  But make your attention move to a mindful close rather than a reflex, and make the movement itself slow and deliberate.”
A previous healthy memory blog post, “Controlling Pain in Our Minds” explores this topic further and discusses the possibility of there being two different neural pathways processing the ‘two darts’.”



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