Study identifies brain regions activated when pain intensity doesn’t match expectation – Wake Forest Baptist Medical Center
From the 27 May 2015 news release
WINSTON-SALEM, N.C. – May 27, 2015 – Picture yourself in a medical office, anxiously awaiting your annual flu shot. The nurse casually states, “This won’t hurt a bit.” But when the needle pierces your skin it hurts, and it hurts a lot. Your expectations have been violated, and not in a good way.
In a study published in the early online edition of the journal PAIN, researchers atWake Forest Baptist Medical Center have identified through imaging the part of the brain that is activated when a person expects one level of pain but experiences another.
“This finding gives us a better understanding of the importance of how our expectations of pain affect the experience of pain,” said Fadel Zeidan, Ph.D., assistant professor of neurobiology and anatomy at Wake Forest Baptist and first author of the study. “This effect shows us how important it is to manage people’s expectations when it comes to pain.”
Previous studies have shown that the expectation of intense pain can make pain feel worse while the expectation of milder pain can make it hurt less. However, the brain mechanisms associated with processing mismatches between expected and experienced pain have been poorly understood.
This Wake Forest Baptist study found that activation of the parietal lobe and insular cortex are involved in processing real-time mismatches between expected and experienced pain.
Reducing pain of varicose vein surgery has been a priority of The Whiteley Clinic.(31 January 2015)
This latest research studied how pain and anxietycan be reduced under local anaesthetic varicose vein surgery. This sort of surgery is also called “keyhole” orendovenous surgery for varicose veins.
Reducing pain of varicose vein surgery – Research from The Whiteley Clinic and University of Surrey
The research showed that both:
- one-to-one talking with a specific nurse
- using a stress ball
both significantly reduced the pain and anxiety of the varicose vein surgery.Interesting, watching a DVD during the surgery reduced the anxiety, but not the pain of varicose vein surgery. Listening to music had no effect.
This study is part of the continuing research program that makes treatment at The Whiteley Clinic unique.This projectwas funded by The Whiteley Clinic andwas performed at our Whiteley Clinic, Guildford.The researcher, Briony Hudson,was supervised by Prof Jane Ogden at The University of Surrey and Prof Mark Whiteley. Her workhas been submitted to the University of Surrey and shewas awarded her PhD in Autumn 2014.The workis going to be published:
- Hudson BF, Ogden J, Whiteley MS. Randomised Controlled Trial to Compare the Effect of Simple Distraction Interventions on Pain and Anxiety Experienced During Conscious Surgery. European Journal of Pain. 2015.
See link: http://www.medicaldaily.com/how-reduce-anxiety-and-pain-during-surgery-small-talk-and-stress-balls-320176
Women’s pain: Common, treatable and often overlooked or mismanaged — ScienceDaily.
Excerpts from the 19 January article
“I can’t tell you the number of women I see who have been told they just have to live with the pain,” Dr. Thomas said. “It’s just heart breaking because many of these women have been suffering a long time. Women, especially older women, are less likely to speak up and seek treatment for their pain.”
Credit: Image courtesy of American Society of Anesthesiologists (ASA)
Despite the variety of effective treatments, and physicians who specialize in treating pain, women often suffer unnecessarily from conditions ranging from backaches to pain after cancer surgery, and also treat their pain with medications that may be ineffective and possibly harmful, according to a review of research related to women and pain by the American Society of Anesthesiologists® (ASA®).
ASA conducted the literature review and issued the Women’s Pain Update to help raise awareness of the many options available to women for controlling both acute and chronic pain, and how a pain medicine specialist can help them choose the right treatment. Among other things, the studies showed that remedies such as music, yoga and rose oil are proven effective for several types of pain, that opioids are often used inappropriately, and that the type of anesthesia used during breast cancer surgery can affect how quickly and comfortably a woman recovers from the operation.
Physician anesthesiologists are doctors who focus on anesthesia and critical care medicine and are among the medical specialists who are experts in the subspecialty of pain medicine, seeing patients in private practices and pain clinics.
Donna-Ann Thomas, M.D., a member of ASA’s Committee on Pain Medicine, frequently sees women who have been suffering in silence for years, with conditions such as a type of back pain that can develop after childbirth, and chronic pain after breast cancer surgery.
“I can’t tell you the number of women I see who have been told they just have to live with the pain,” Dr. Thomas said of women who come to her with sciatica, a type of back pain that radiates down the leg. “It’s just heart breaking because many of these women have been suffering a long time. Women, especially older women, are less likely to speak up and seek treatment for their pain.”
Persistent pain estimated in 19 percent of U.S. Adults — ScienceDaily.
October 27, 2014
American Pain Society
39 million people in the United States, or 19 percent have persistent pain, and the incidence varies according to age and gender, a new study reports. The authors noted that persistent pain correlated with other indices of health-related quality of life, such as anxiety, depression and fatigue. Individuals with those conditions were far more likely to report persistent pain.
Excerpt from the news story:
n 2011, the Institute of Medicine reported that 100 million Americans have chronic pain. The authors explained that the disparity between the estimated pain incidence in their study and what the IOM reported is attributable almost entirely to differences in operational definitions of persistent pain.
In the 2010 NHIS, an estimated 60 percent of adults reported lower back pain in the past three months, and all of them would have been described in the IOM report as having chronic pain. However, only 42 percent of the NHIS study respondents with back pain described their pain as frequent or daily and lasting more than three months.
From a public health perspective the difference is significant. Those with persistent pain have high rates of work disability, fatigue, anxiety and depression. They also are at higher risk for long-term exposure to and dependency on pain medications.
The authors concluded that measuring pain persistence has policy implications because persistent pain is an indicator of an unmet medical need for pain management in the general population, as well as a risk factor for anxiety and depression.
From the National Center for Complementary and Alternative Medicine
Pain is the most common reason for seeking medical care. It is also a common reason why people turn to complementary health approaches.
We have collected our information on pain into an eBook you can download to your computer or mobile device.
If you have a Web-enabled device:
From the 4 April 2014 post by Karen Sibert, MD at The Health Care Blog
The problem of pain, from the viewpoint of British novelist and theologian C. S. Lewis, is how to reconcile the reality of suffering with belief in a just and benevolent God.
The American physician’s problem with pain is less cosmic and more concrete. For physicians today in nearly every specialty, the problem of pain is how to treat it responsibly, stay on the good side of the Drug Enforcement Administration (DEA), and still score high marks in patient satisfaction surveys.
If a physician recommends conservative treatment measures for pain–such as ibuprofen and physical therapy–the patient may be unhappy with the treatment plan. If the physician prescribes controlled drugs too readily, he or she may come under fire for irresponsible prescription practices that addict patients to powerful pain medications such as Vicodin and OxyContin.
One way to address the growing heroin epidemic? Address lifestyle and environment components.
Certainly would be a public health way to stem folks dependence on substances that can often diminish quality of life and death.
From the 4 January 2014 Science Daily article (read the entire article at this link)
Researchers have discovered that sensitivity to pain could be altered by a person’s lifestyle and environment throughout their lifetime. The study is the first to find that pain sensitivity, previously thought to be relatively inflexible, can change as a result of genes being switched on or off by lifestyle and environmental factors — a process called epigenetics, which chemically alters the expression of genes.
Finding it easy to empathize with these patients because of a short term musculoskeletal condition.
Hoping that health care providers will be able to find ways to treat all who experience this chronic condition without interference from the government.
From the 3 December 2013 University of Warwick press release via EurekAlert
People who suffer with chronic musculoskeletal pain face a daily struggle with their sense of self and find it difficult to prove the legitimacy of their condition.
A new study, funded by the National Institute for Health Research Health Services and Delivery Research (HS&DR) Programme, systematically searches for, and makes sense of, the growing body of qualitative research on musculoskeletal pain to help understand the experiences of patients suffering from chronic pain.
A number of concerning themes arose from the study, published today in the Health Services and Delivery Research journal, which highlighted:
- Patients struggling with the fundamental relationship with their body, and a sense that it is no longer ‘the real me’.
- A loss of certainty for the future, and being constantly aware of the restrictions of their body.
- Feeling lost in the health care system; feeling as though there is no answer to their pain.
- Finding it impossible to ‘prove’ their pain; “if I appear ‘too sick’ or ‘not sick enough’ then no one will believe me”
Kate Seers, Professor of Health Research at Warwick Medical School and Director of the Royal College of Nursing Research Institute, was a collaborator on this study. She explains, “Being able to collate this vast amount of information from patients paints a worrying picture about the experiences they have with chronic non-malignant pain. Our goal has to be to use this information to improve our understanding of their condition and, consequently, the quality of care we can provide.”
“Having patients feel that they have to legitimise their pain, and the sense that doctors might not believe them, is something that should really concern us as health care professionals.”
The study also identified a number of ways in which patients can move forward with their lives.
The key for some people appears to be building a new relationship with the body and redefining what is ‘normal’, rather than trying to maintain the lifestyle before the pain. Developing an understanding of what the body is capable of and becoming confident to make choices can aid the process of living with musculoskeletal pain.
Dr Francine Toye, of Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, explains, “This paper shows there can be value in discussing the condition with other people who are going through the same experience and knowing that you are not alone. Of course you can learn about your condition from various sources, but sharing your experience seems to really help people to move forward.”
77 studies of chronic musculoskeletal pain were included in the meta-ethnography, with collaborators from Nuffield Orthopaedic Centre, the University of Warwick, Glasgow Caledonian University, Leeds Metropolitan University, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and the University of Calgary.
From the Tel Aviv University press release as reported at the 5 November 2013
PUBLIC RELEASE DATE:
Contact: George Hunka
American Friends of Tel Aviv University
Torture permanently damages normal perception of pain
Tel Aviv University researchers study the long-term effects of torture on the human pain system
Israeli soldiers captured during the 1973 Yom Kippur War were subjected to brutal torture in Egypt and Syria. Held alone in tiny, filthy spaces for weeks or months, sometimes handcuffed and blindfolded, they suffered severe beatings, burns, electric shocks, starvation, and worse. And rather than receiving treatment, additional torture was inflicted on existing wounds.
Forty years later, research by Prof. Ruth Defrin of the Department of Physical Therapy in the Sackler Faculty of Medicine at Tel Aviv University shows that the ex-prisoners of war (POWs), continue to suffer from dysfunctional pain perception and regulation, likely as a result of their torture. The study — conducted in collaboration with Prof. Zahava Solomon and Prof. Karni Ginzburg of TAU’s Bob Shapell School of Social Work and Prof. Mario Mikulincer of the School of Psychology at the Interdisciplinary Center, Herzliya — was published in the European Journal of Pain.
“The human body’s pain system can either inhibit or excite pain. It’s two sides of the same coin,” says Prof. Defrin. “Usually, when it does more of one, it does less of the other. But in Israeli ex-POWs, torture appears to have caused dysfunction in both directions. Our findings emphasize that tissue damage can have long-term systemic effects and needs to be treated immediately.”
A painful legacy
The study focused on 104 combat veterans of the Yom Kippur War. Sixty of the men were taken prisoner during the war, and 44 of them were not. In the study, all were put through a battery of psychophysical pain tests — applying a heating device to one arm, submerging the other arm in a hot water bath, and pressing a nylon fiber into a middle finger. They also filled out psychological questionnaires.
The ex-POWs exhibited diminished pain inhibition (the degree to which the body eases one pain in response to another) and heightened pain excitation (the degree to which repeated exposure to the same sensation heightens the resulting pain). Based on these novel findings, the researchers conclude that the torture survivors’ bodies now regulate pain in a dysfunctional way.
It is not entirely clear whether the dysfunction is the result of years of chronic pain or of the original torture itself. But the ex-POWs exhibited worse pain regulation than the non-POW chronic pain sufferers in the study. And a statistical analysis of the test data also suggested that being tortured had a direct effect on their ability to regulate pain.
The researchers say non-physical torture may have also contributed to the ex-POWs’ chronic pain. Among other forms of oppression and humiliation, the ex-POWs were not allowed to use the toilet, cursed at and threatened, told demoralizing misinformation about their loved ones, and exposed to mock executions. In the later stages of captivity, most of the POWs were transferred to a group cell, where social isolation was replaced by intense friction, crowding, and loss of privacy.
“We think psychological torture also affects the physiological pain system,” says Prof. Defrin. “We still have to fully analyze the data, but preliminary analysis suggests there is a connection.”
American Friends of Tel Aviv University supports Israel’s leading, most comprehensive and most sought-after center of higher learning, Tel Aviv University (TAU). Rooted in a pan-disciplinary approach to education, TAU is internationally recognized for the scope and groundbreaking nature of its research and scholarship — attracting world-class faculty and consistently producing cutting-edge work with profound implications for the future. TAU is independently ranked 116th among the world’s top universities and #1 in Israel. It joins a handful of elite international universities that rank among the best producers of successful startups.
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By Kristina Fiore, Staff Writer, MedPage Today,Published: October 24, 2012
A push to treat chronic pain and financial disincentives for treating addiction may pressure clinicians into prescribing opioids for patients who are already addicted, a researcher suggested.
Over the past decade, there’s been a perfect storm of changing clinician attitudes toward pain treatment and patient attitudes towards suffering, combined with a lack of compensation for time-consuming clinic visits such as addiction counseling, Anna Lembke, MD, of Stanford University, wrote in a perspective in the New England Journal of Medicine.
That may be leading doctors to write scripts for pain pills even if they know those patients are abusing their medications, Lembke wrote.
“Treatment of pain is held up as the holy grail of compassionate medical care,” she wrote, and clinicians have, over the last decade, felt more compelled to deliver treatment.
They also have the additional pressure of consumer ratings sites, because patients who are dissatisfied may turn around and leave a less-than-favorable review online. Lembke cites the example of one colleague who will occasionally bite the bullet: “Sometimes I just have to do the right thing and refuse to prescribe them, even if I know they’re going to go on Yelp and give me a bad rating,” the colleague told her…
Hippocrates stares down at the UCSF doctors, continually reminding them to stick to his oath.
From the 14 Novemer 2011 Eureka news alert
Research includes drug and non-drug interventions
Washington — Scientists are discovering promising approaches to treating pain, one of the most common and debilitating neurological complaints, according to research released today at Neuroscience 2011, the annual meeting of the Society for Neuroscience and the world’s largest source of emerging news about brain science and health. Studies show that “mirror box therapy” can help reduce arthritis-related pain, and that a new opioid-like drug may be able to relieve acute pain without the euphoric effects that can lead to dependency. Additional research also identifies the possible neurobiological source of common side effects of morphine.
Specifically, today’s new findings show that:
- Two of morphine’s most common side effects, itch and headache, may be due to the drug’s activation of immune cells in the membrane surrounding the brain and spinal cord (Julie Wieseler, PhD, abstract 178.12, see summary attached).
- A visual feedback technique called mirror box therapy can help alleviate hand pain in patients with arthritis (Laura Case, abstract 72.03, see summary attached).
- In an animal study, a novel drug relieves acute pain without the dangerous side effects associated with opioid painkillers such as morphine (Stephen Harrison, PhD, abstract 178.10, see summary attached).
Other recent findings discussed show:
- A gene therapy treatment reduced pain in 10 people in a Phase I clinical trial that tested for treatment safety (David Fink, MD, see attached speaker’s summary).
- A naturally occurring protein that supports the survival and growth of neurons in the brain and spinal cord may be a potential therapeutic intervention to prevent chronic pain following spinal cord injuries, according to animal research (Ching-Yi Lin, PhD, see attached speaker’s summary).
“Pain is one of the most intransigent and difficult symptoms to treat,” said Allan I. Basbaum, PhD, FRS, of the University of California, San Francisco, press conference moderator and expert on the neurobiology of pain. “These studies and others are helping us better understand the complex neural pathways involved in pain and the long-term consequences of injury. With this, researchers will be better poised to develop approaches to alleviate pain and aid in recovery from injuries.”
This research was supported by national funding agencies, such as the National Institutes of Health, as well as private and philanthropic organizations. Dr. Basbaum has consulted with Nektar Therapeutics, Inc., but was not involved in research presented today.
View full release at www.sfn.org/newsroom.
The American Pain Foundation will soon be launching a PainSafe (Safety & Access For Everyone) module on CAM and pain. This module, created with materials and assistance from NCCAM, aims to educate and empower both consumers and health care professionals.
From the 15 August Eureka news item
Pain care management needs to be improved, with health care professionals committing to improve care as well as a retooling of the health care system to help people who are suffering, states an editorial in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/site/embargo/cmaj111065.pdf.
According to a recent analysis, chronic pain affects people of all ages, with an estimated 500,000 Canadians aged 12 to 44 years, 38% of seniors in long-term care institutions and 27% of seniors living at home experiencing regular pain.
“Experts agree that much can be done now with newer analgesics, nonpharmacologic techniques such as nerve blocks and physical therapies, as well as spiritual and supportive care,” write Drs. Noni MacDonald, Ken Flegel, Paul Hébert and Matthew Stanbrook. “Availability of quality care for pain is the major problem. Health professionals have not mounted a response commensurate with the magnitude of the problem.”
The authors argue for a broad strategy to help increase pain management expertise, including education, technology, and supported self-care and lay coaching.
From the 26 July 2011 Science Daily article
All over the world, patients with chronic pain struggle to express how they feel to the doctors and health-care providers who are trying to understand and treat them.
Now, a University at Buffalo psychiatrist is attempting to help patients suffering from chronic pain and their doctors by drawing on ontology, the branch of philosophy concerned with the nature of being or existence.
The research will be discussed during a tutorial he will give at the International Conference on Biomedical Ontology, sponsored by UB, that will be held in Buffalo July 26-30.
“Pain research is very difficult because nothing allows the physician to see the patient’s pain directly,” says Werner Ceusters, MD, professor of psychiatry in UB’s School of Medicine and Biomedical Sciences, and principal investigator on a new National Institutes of Health grant, An Ontology for Pain and Related Disability, Mental Health and Quality of Life.
“The patient has to describe what he or she is feeling.”
Read the article
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From the 12 April 2011 Medical News Today article
Torture. The United Nations defines it as the “infliction of severe physical or mental pain or suffering.” But how severe is severe? That judgment determines whether or not the law classifies an interrogation practice as torture.
Now, a study published in an upcoming issue ofPsychological Science, a journal of the Association for Psychological Science, condemns this method of classification as essentially flawed.
[For suggestions on how to get this article for free or at low cost, click here ]
The reason: The people estimating the severity of pain aren’t experiencing that pain-so they underestimate it.
As a result, many acts of torture are not classified-or prohibited-as torture, say authors, Loran F. Nordgren of Northwestern University’s Kellogg School of Management, Mary-Hunter Morris of Harvard Law School, and George Loewenstein of Carnegie Mellon University.
The researchers were moved to undertake the study by their alarm at the Bush Administration’s defense of “enhanced interrogation techniques,” such as stresspostures and waterboarding. In court and the media, officials minimized the psychological and physical distress caused by these techniques-and insisted they were not torture.
In this denial, the authors saw a perfect demonstration of a psychological phenomenon called the “empathy gap,” says Loewenstein: “People in one affective state”-hunger, anger, pain-“cannot appreciate or predict another one.” If you’re warm, you can’t imagine the misery of being cold; if you’re rested, sleep deprivation doesn’t seem so bad…
…The study’s conclusion: “The legal standard for evaluating torture is psychologically untenable.”
So what can be done? First, overcompensate. “Knowing that we tend to be biased toward not counting torture as torture, we should define torture very liberally, very inclusively,” says Loewenstein. And don’t trust empathy. “This is an area where we can’t rely on our emotional system to guide us. We have to use our intellect.”
From the April 8 Medical News Today item
Focus, zen, meditate and your pain may go away or diminish. A new MRI brain image study shows that just after a short period of meditation, pain intensity is weakened when subjected to unpleasent stimuli such as extreme heat.
The study participants were taught a meditation technique known as focused attention, which involves paying close attention to breathing patterns while acknowledging and letting go of thoughts that distract you.
Fadel Zeidan, PhD, who is a postdoctoral fellow at Wake Forest University School of Medicine, says:
“This is the first study to show that only a little over an hour of meditation training can dramatically reduce both the experience of pain and pain-related brain activation.”…
….Source: Wake Forest Baptist Medical Center News Release
From the March 8, 2011 Science Daily news item
ScienceDaily (Mar. 8, 2011) — Lent in the Christian tradition is a time of sacrifice and penance. It also is a period of purification and enlightenment. Pain purifies. It atones for sin and cleanses the soul. Or at least that’s the idea. Theological questions aside, can self-inflicted pain really alleviate the guilt associated with immoral acts? A new study published in Psychological Science, a journal of the Association for Psychological Science, explores the psychological consequences of experiencing bodily pain.
From the Mayo Clinic article by Daniel K. Hall-Flavin, M.D.
Pain and depression are closely related. Depression can cause pain — and pain can cause depression. Sometimes pain and depression create a vicious cycle in which pain worsens symptoms of depression, and then the resulting depression worsens feelings of pain.
In many people, depression causes unexplained physical symptoms such as back pain or headaches. Sometimes this kind of pain is the first or the only sign of depression.
Pain and the problems it causes can wear you down over time, and may begin to affect your mood. Chronic pain causes a number of problems that can lead to depression, such as trouble sleeping and stress. Disabling pain can cause low self-esteem due to work, legal or financial issues. Depression doesn’t just occur with pain resulting from an injury. It’s also common in people who have pain linked to a health condition such as diabetes or migraines.
To get symptoms of pain and depression under control, you may need separate treatment for each condition. However, some treatments may help with both.
Because of shared chemical messengers in the brain, antidepressant medications can relieve both pain and depression.
Psychological counseling (psychotherapy) can be effective in treating both conditions.
Stress-reduction techniques, meditation, staying active, journaling and other strategies also may help.
Treatment for co-occurring pain and depression may be most effective when it involves a combination of treatments.
If you have pain and depression, get help before your symptoms worsen. You don’t have to be miserable. Getting the right treatment can help you start enjoying life again.
Some related links
Pain (MedlinePlus topic) has links to overviews, latest news, alternative therapies, health check tools, videos, research, and more
Depression (MedlinePlus topic) has links to overviews, latest news, treatments, related issues, and more
Depression (eMedicine Health) includes information on types of depression, causes, treatments, getting help, and much more
American Chronic Pain Association includes a consumer guide to pain medications and treatments, pain management tools
From a PsycPost December 8 2010 news item
Zen meditation has many health benefits, including a reduced sensitivity to pain. According to new research from the Université de Montréal, meditators do feel pain but they simply don’t dwell on it as much. These findings, published in the month’s issue of Pain, may have implications for chronic pain sufferers, such as those with arthritis, back pain or cancer.
“Our previous research found that Zen meditators have lower pain sensitivity. The aim of the current study was to determine how they are achieving this,” says senior author Pierre Rainville, researcher at the Université de Montréal and the Institut universitaire de gériatrie de Montréal. “Using functional magnetic resonance imaging, we demonstrated that although the meditators were aware of the pain, this sensation wasn’t processed in the part of their brains responsible for appraisal, reasoning or memory formation. We think that they feel the sensations, but cut the process short, refraining from interpretation or labeling of the stimuli as painful.”
Training the brain
Rainville and his colleagues compared the response of 13 Zen meditators to 13 non-meditators to a painful heat stimulus. Pain perception was measured and compared with functional MRI data. The most experienced Zen practitioners showed lower pain responses and decreased activity in the brain areas responsible for cognition, emotion and memory (the prefrontal cortex, amygdala and hippocampus). In addition, there was a decrease in the communication between a part of the brain that senses the pain and the prefrontal cortex.
“Our findings lead to new insights into mind/brain function,” says first author, Joshua Grant, a doctoral student at the Université de Montréal. “These results challenge current concepts of mental control, which is thought to be achieved by increasing cognitive activity or effort. Instead, we suggest it is possible to self-regulate in a more passive manner, by ‘turning off’ certain areas of the brain, which in this case are normally involved in processing pain.”
“The results suggest that Zen meditators may have a training-related ability to disengage some higher-order brain processes, while still experiencing the stimulus,” says Rainville. “Such an ability could have widespread and profound implications for pain and emotion regulation and cognitive control. This behaviour is consistent with the mindset of Zen and with the notion of mindfulness.”
Excerpts from the Joint Commission Patient Handout
Questions To Ask Your Caregivers
What pain medicine is being ordered or given to you?
Can you explain the doses and times that the
medicine needs to be taken?
What should you do if the medicine makes you sick
to your stomach?
What can you do if the pain medicine is not working?
What else can you do to help treat your pain?
Are there other ways to relieve pain?
That will depend on your illness or condition and how
much pain you have. Sometimes pain can be relieved
in other ways. Some other treatments for pain are
Acupuncture, which uses small needles to block pain
Taking your mind off the pain with movies, games
Electrical nerve stimulation, which uses small jolts
of electricity to block pain
Physical therapy Exercise
Hypnosis Heat or cold
The Joint Commissionis an ” independent, not-for-profit organization, The Joint Commission accredits and certifies more than 18,000 health care organizations and programs in the United States”
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They are also more likely to have multiple painful conditions at the same time, expert says
Among the variables between the sexes are hormonal and genetic factors.
“Women tend to focus on the emotional aspects of pain,” ….. “Men tend to focus on the physical sensations they experience. Women who concentrate on the emotional aspects of their pain may actually experience more pain as a result, possibly because the emotions associated with pain are negative.”
Among other things, Kelly [Jennifer Kelly, of the Atlanta Center for Behavioral Medicine] encouraged practitioners to allow patients, especially women, to take an active role in their treatment, to provide psychological support and to offer relaxation techniques and biofeedback.
The U.S. National Institute of Neurological Disorders and Stroke has more about chronic pain.