Monday, November 12, 2012

Your pain experience is unique and personal

Pain is a poorly understood phenomenon.  Pain has been treated and studied for so long, and Western medicine has made extraordinary advances in so many areas,  but we still have only a fundamental understanding of pain's mechanism.  Pain is a complex mechanism that involves physiology, spirituality, emotions, and perceptions.  As in all health issues, it involves the mind/body connection.  When people are in pain it is a completely subjective and personal experience.  Pain makes people feel emotionally out of control, which increases anxiety levels and increases the intensity of the pain experience.  That is why lavendar aromatherapy decreases the perception of pain; lavendar is a calming herb.  When I was working with an Interventional Radiology Department I observed that women experienced more pain than men when a chemotherapy port was placed in the upper chest.  When I presented that information to the port placement team it was decided to give women a prescription for pain medication before they were discharged back home.  In my follow up calls women reported they didn't fill the analgesic prescription, they still had pain, but they tolerated that pain better because they knew they were in control and could opt to fill the analgesic prescription if they wished. I have also observed from my own experience that the more pain medication I use the more I seem to have a rebound increase in pain.  Therefore I use pain medication as judiciously as possible.  That rebound pain experience doesn't occur with random extra doses of analgesics, but if I use an increased amount of analgesics routinely the rebound mechanism does occur.  So I save the Vicodin use for times when I am in a flare, which is sometimes related to a recent increase in activity or times of stressful situations.  I also save Vicodin for night time to help with sleep when pain is flaring.  The other strategies I use to decrease my pain experience is to assign less importance to pain and focus on activities that interest me.  I take frequent rest periods throughout each day and I also keep my sense of humor.  My sense of humor is a key component that helps me to assign less importance to my pain.  When I notice that my pain is increased in a particular area I set that pain aside and make a mental note to ignore the pain.  That doesn't totally relieve my pain, but I do have a better ability to tolerate that pain.  The same is true for other fibro symptoms that may nag at me throughout the day.  I also focus on having a positive mental attitude as much as possible, because that helps me to minimize my pain.  In addition, I work to limit the amount of chaos and stress in my life so I can save my emotional and physical energy for those things that must be attended to.   Several weeks ago I read a short article about why athletes can handle more pain than the average person.  It is an interesting article that confirmed some of the things that I have observed about pain.  I have shared this article below so you would have an opportunity to either learn more about your pain experience or remind you of those bits of information about pain that you may have forgotten.  I hope you find this article as interesting as I did! 

Why Athletes Can Handle More Pain

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Researchers reporting in the journal Pain looked at 15 studies that examined pain threshold and tolerance in athletes and non-athletes. While both groups had similar pain thresholds (the point when pain is felt), athletes consistently tolerated more pain (the maximum amount one can handle before it becomes unbearable). Many “game” sport athletes showed a higher pain tolerance than endurance athletes, although this varied by type of sport. Another study looked at gender and found male athletes tolerated pain better than women.

More clues point toward a common cognitive strategy athletes use: Association/Disassociation. Association occurs when people concentrate on the act itself (like dribbling a soccer ball or calculating running splits), while dissociation occurs as people think of something positive to distract them. Both strategies help increase pain tolerance and performance in athletes by reducing physiological stress but in different ways. Dissociation may increase pain threshold when working at a low to moderate intensity level, while association is more effective at higher intensities. Using these instinctive tactics may also vary by gender, as women tend to be more dissociative than men.
The one thing missing from these studies is why athletes can handle the hurt. Researchers didn’t crack the code, but they suggest resistance to pain can be learned over time, and an increase in exercise intensity can lead to endorphin release. Others suggest it’s because athletes are incredibly motivated to push through the pain in order to break a personal record, win a medal, or prove they’ve performed to the best of their ability.

Unfortunately, joining a kickball league won’t instantly make us power through the tough stuff. Pain tolerance depends on a range of factors, like genetics and the type of sport. For example, researchers found people who carry a specific gene variant are more likely to report higher levels of pain, while contact-sport athletes may be able to grin and bear it more than others. One thing is pretty certain though — tolerating pain has a lot to do with mind over matter. So whether you’re a world-class athlete or a club frisbee fiend, when the goin’ gets tough, stick to positive thinking to help hurdle the discomfort.

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The pain experience is a personal experience that is as different from person to person as fingerprints are different.  Denying pain has been viewed as a macho right of passage and people that were unable to tolerate pain as well were viewed as "whimps" by many.  This is just another pain myth. People with fibromyalgia have a physiological process of centralized sensitization that has itensified the pain we experience.  That complicates our ability to manage pain and that cannot be denied.  Your pain experience is real and your pain management plan must be individualized specifically for you.  Your pain will be different every day and a key part of that may be related to how well you feel physically and/or emotionally that day and the level of stress or chaos in your life.  The mind/body connection is so closely aligned and our physical well-being is frequently dependent on our emotional well-being and vice versa.  It is also well known that emotional well-being has a direct influence on our immune system.

Your pain is very real and there is no denying that and your quality of life depends on good pain management.  Using a multifaceted approach to your pain management plan is more beneficial and cares for both your mind and your body . . . all that makes up the totality and essence of you.  May you have pain free moments in every day.  Blessings to you as you work to manage your pain and your emotional and physical well-being!
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