How to Manage Pain


A number of technologically advanced methods, from electrical stimulation to potent drugs, have been developed to help people deal with chronic pain.  Some of these can be quite effective.  Yet to a surprising degree, pain can  be managed at the level of the mind -- sometimes as effectively as through medical means.

Unlike many other cultures, where pain is seen as part of life, the typical American attitude to pain is, Turn it off -- as soon as possible.  Television ads for analgesics carry the message, You don't deserved pain, and our product will get rid of it in only 20 seconds -- our rival's product will take 30 seconds.

I don't mean to say that pain-relieving medications should be abandoned -- for they can be very valuable.

The danger occurs when people think first of getting rid of the pain -- and are no longer impelled by it to address the issues it raises. 

If we run to the medicine cabinet every time we feel a twinge, we deprive ourselves of valuable advice from our bodies... and may fail to take the avoiding actions that would prevent the problem from recurring.

After many years of working with leprosy patients and diabetics for whom lack of pain sensitivity can lead to loss of limbs and other tragic consequences, I have come to believe that pain is actually a great gift.  It compels us to notice when some part of the body is in danger.  People who don't have the ability to feel pain envy it:   They don't know when to snatch their hands from a cooking pot that they don't know is hot, avoid walking on an injured foot or seek treatment for a minor infection before it becomes advanced.

Instead of seeing pain as an enemy to be attacked and destroyed, we can benefit by listening to what our aches and pains have to say -- and in doing so, we'll often find that they are friiendly.

Example:  If I get a headache, instead of thinking, What a nuisance -- I haven't got time for this,  I take an hour or so to think through what might be causing the pain.  Am I accepting too much stress?  Have I stopped living in accordance with my priorities?  Have I been pushing myself beyond endurance?

I believe that if people would take the time to resolve major conflicts in their lives -- instead of dulling the pain so they can rush back to their destructive routines -- they would suffer far less from headaches, stomachaches, back pain and other chronic problems.

We can deal with pain more constructively by understanding and appreciating how the system works.

Pain has Three Stages

Pain begins with a signal  (Stage 1) sent by nerve endings at the point that is damaged or in danger.

This signal travels along the spinal cord as a message to the brain (Stage 2).  Often, reflexes will cause us to take avoiding action before the next stage is reached -- and we're never even aware of a pain sensation. 

In addition, distractions -- such as the excitement of an athletic event or family reunion, the tension of a political debate, the thrill of an amusement park ride or the stress of battle -- can temporarily prevent transmission of the pain message.  Think of the base of the brain as a gateway through which pain signals must pass before they're recognized and interpreted by the brain.  When the body is sending many kinds of nerve signals at once, a kind of bottleneck forms -- not all the signals can get through.

(Stage 3)

The conscious perception of pain only occurs after the message reaches the brain -- and the brain chooses a response.  Many kinds of narcotics work at this level -- but while these drugs can relieve pain, many are highly addictive.  Fortunately, it's at this third stage that pain has the greatest potential to be affected for better or worse, by what we think about it.

Using the mind to manage pain. . .

Even at the signal and message stages of pain, over which we have little conscious control, we can still make a profound difference by listening to the pain and looking for a pattern.

Under what conditions does discomfort occur?  Can we experiment with healthy changes -- in movement, diet, posture, sleeping habits or other practices -- to lessen it?

Pain and the mind. . .

But when our attempts at avoiding stressful conditions fail to relieve chronic pain, we can draw on the power of the mind to affect our perception of it.

We can learn about those factors that magnify the awareness of pain...find ways to control those factors and begin to manage the pain, instead of feeling that pain is controlling us.

Factors that can exacerbate pain include...

Fear:  If I feel a twinge and wonder if it's arthritis or cancer, I will become obsessed with the pain, and my worry will make me less able to tolerate it.

  • Antidote:  Get the facts.  Control.  If I believe I have some influence over the source of pain, I will handle it more comfortably.   Obviously, we can't always control the diseases or injuries that give rise to chronic pain.  But we can develop a sense of control over our responses by...
  • Seeing pain as a friend rather than an enemy
  • Recognizing that pain is a protective system.
  • Gathering good information about the source of the pain.
  • Respecting what it tells us about our limits.
  • Appreciating the fact that the system works.
  • Inactivity:  When we can't get rid of pain, a common response is to stop all  activity -- which can lead us to focus on the pain to the exclusion of everything else.  That is one reason pain at night almost always feels worse than during the day -- we don't have our normal routines to distract us.   

    It's true that you should take advantage of pain's protective function by limiting activities that hurt the affected area.  But that doesn't mean eliminating every other stimulus from your life.

    • Antidote:  Healthy distraction.  Acknowledge your limits and use those part of your body that do function normally.  If your hand hurts, go for a walk.  If you're recovering from foot surgery, write a letter to a friend.
    • One of the most effective forms of distraction is helping others, whether by growing flowers and delivering them to someone who's ill or volunteering to spend time with children in a hospital or daycare center.

    Anger and bitterness.  As a hand surgeon [Dr. Paul] is sometimes called upon to operate on someone who has filed suit against a motorist or other person responsible for his/her injury.

    [He's] not against fair compensation, but today's awards are often so high that it pays the person to be deformed... and I've noticed that many of the patients involved in bitter lawsuits take much longer to heal.  I don't believe they're faking or imagining the pain -- but their anger at and desire to punish the person who hurt them seems to enhance the pain... and may even interfere with the body's healing mechanism.

    • Antidote:  Forgiveness.  Whether our anger is recent or has lasted for years, the act of forgiveness can release us from emotional as well as physical misery.  Sometimes, this requires the assistance of a compassionate counselor who can help us to unearth buried resentments... or remind us that the person who wronged us was wrestling with his/her own pain.
    • Most of use have had the experience of being forgiven by someone we have wronged.  Extending that same balm to others can be profoundly soothing.
    • Forgiveness makes room for the healing power of gratitude, awe at the miraculous efficiency of all our body's mechanisms, including sight and hearing as well as pain, and the powerful recognition that a life without pain would be miserable indeed.
    Source:  Paul Brand, MD, world-renowned hand surgeon and leprosy specialist.  His years of pioneering work among leprosy patients earned him numerous prestigious awards.  Dr. Brand has coauthored many books, including, Pain:  The Gift Nobody Wants.  Harper Collins.

    -- Excerpt from Doctor's Little Black Bag of Remedies and Cures.  Boardroom