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The Nocebo Effect and Pain Management

There’s an excellent reason some doctors don’t warn their patients about medication side effects. When you expect negative symptoms, you’re more likely to experience them, a phenomenon known as the nocebo effect.

When researchers used fMRI to uncover the physiology behind this tendency, they found that no less than 12 regions of the brain were involved. Everything from the rational prefrontal cortex to the more emotional temporal gyrus responded to health expectations. The brain is a powerful and mysterious organ, capable of changing how you experience your body. Expect pain, and you’re likely to feel it. Expect nausea, and your brain will make it happen, too.

Medical trials frequently suffer under the weight of the nocebo effect. 11% of placebo takers dropped out of a fibromyalgia study due to perceived side effects. 26% of the control group in a lactose intolerance trial suffered gastrointestinal symptoms. Getting beyond the nocebo effect is no easy task. If you’re a suggestible person, you’re likely to experience it at least once, and your healthcare worker is the best tool you have for combating it.

The Power of Words

Even the most sensitive healthcare workers can trigger a nocebo effect, so the only way over the hurdle is through awareness. Secret-keeping is not a solution. Your physician must understand the power of words, which can increase reports of bad reactions by as much as 2000 times.

JAMA nocebo researcher, Ulrike Bingel has found that clear and thorough communication is the best tool to overcome false adverse effects. Your physician should describe your drug’s effects and their likelihood clearly, without jargon. Doctors at Pain Stop Clinics remain aware of the power of the mind so that they can better guide patients away from their fears with active listening, sensitivity, and realistic hope.

Can Placebos Relieve Pain?

When doctors run clinical trials on animals, they have to do so in a way that doesn’t trigger the placebo effect. If this odd medical quirk is powerful in four legged creatures, how much more potent is it in humans? Ted Kaptchuk decided to find out. His study of sham acupuncture treatments and genuine asthma inhalers found that the placebo effect changed the way patients perceived their breathing, but did not change their lung function. Yet contrary to popular belief, the placebo effect isn’t a magical cure, and this must be respected.

Placebos and Pain Management

Chronic pain patients are particularly prone to suggestion. The pain threshold rises and falls in direct relation to your thoughts. When researchers told their subjects that ice water would improve their pain, they tolerated it better. When they were told the opposite, their pain tolerance shrank. The challenge of treating pain lies in taking patients’ reports seriously while simultaneously activating the placebo effect. Your mind is powerful enough to reframe your pain, help you to relax into it more, and endure it more easily.

Placebos vs. Evidence-Based Treatments

In another study, migraine patients who took a placebo labelled as a migraine therapy experienced almost half the pain relief of patients who took a genuine migraine therapy. There is thus no substitute for evidence-based treatments. Physicians who treat pain syndromes must never use the power of positive thinking as a substitute for genuine therapies. They must take place in an environment that is honest, positive, and empathetic, but doctors must also get to the core of the problem.

Remove the cause and you remove the pain, which is why Pain Stop approaches interventions at their root. Patients don’t merely want their pain to stop, but to stop permanently and with minimal side effects. That is what they deserve.

How Evolution Causes Back Pain

Mankind might be at the top of the food chain, but it’s not because we have perfectly adapted bodies. Evolution has done a fair job of providing opposable thumbs and an efficient brain, but perhaps the back could use some improvements.

A Body Made of Paperclips

Jeremy DeSilva said, “Evolution works with duct tape and paperclips,” and that applies more to the spine than most other body parts. It evolved to suit four-legged movement, and it’s not yet developed to suit bipedal postures perfectly. Richard Dawkins says the human spine is so similar to a gorilla spine that it’s barely adapted to a bipedal gate.

The back was built to arch like a bow so that it would carry the weight of organs in the undercarriage. Standing up threw the structure out of balance, curving the back in the other direction. This places pressure on the lower back, leading to pain.

The curvature of a normal human spine tends to cause a lesion between discs in the lower back. At its worst, it’s prone to scoliosis and sciatica. The spinal cord is also unable to heal fully if damaged because its neurons are too specialized.

Coping with Pain

The back is the most common region for chronic pain. Ergonomic living is an excellent preventative tool, but when the damage has already been done, more work is required. A pain management specialist may be needed to put together a treatment team for your unique problem. Stretches and other exercises may be used to release tight muscles, and specialized treatments such as low impact water therapy and neurological care may be indicated. Your Pain Stop Clinic will take a multi-disciplinary approach to your pain, giving you the best chance at relief.

Evolutionary Biologists Puzzled Over Pain

Painful tissue damage and inflammation tell you that they are there and need care, but even Richard Dawkins can’t find the evolutionary advantage of agony over a more tolerable, subtle ache or other signal. Without pain, you wouldn’t know that fire is dangerous or that your aching back needs treatment. Soreness is one of the crowning achievements of natural selection, but the body takes it to unnecessary heights.

Maybe the brain needs to tell us which sensations to prioritise. If you’ve not taken in fluids for two days, for example, your thirst is more important than your slightly bruised foot. If you’ve put your hand in a fire, though, it’s best to rescue your limb before you go hunting for the nearest stream. Varying intensities tell you what requires urgent action.

Neurology’s Viewpoint

People with disorders that prevent pain “usually come to a bad end,” says Dawkins. These patients must learn how to identify signs of harmful burns and breakages, but they often fail to adjust. They tend to suffer serious disabilities as a result.

It’s doubtful you’d take a more tolerable signal seriously, which lends credibility to the Darwinian explanation, but that doesn’t tell us the point of migraines and other painful disorders. Neuroscientist Vincenzo Bonavita believes that these seemingly useless pain signals force you to disengage from active life and get the necessary rest. In other words, even when that backache or headache isn’t pointing to tissue damage, you should take it seriously.

Pain is an important part of your health. Your nerves’ signals are as precise as a Geiger Counter. If you’re hurting, your body is telling you to hunt for a cause and some relief, so you need a pain specialist who takes your symptoms seriously. Pain Stop Clinics will do precisely that.

What are trigger points?

The term “trigger point” comes with enough contention to make a doctor drop her stethoscope. It’s said to be an area of sensitive connective tissue that radiates pain, and while myofascial tissue is prone to painful reactions to repetitive contractions, myofascial tissue isn’t limited to isolated trigger points. Aches in these areas are believed to be peripheral nerve pain or spasms. Diagnosis based on trigger point science is sketchy, so it’s important that any widespread pain be assessed under the banner of musculoskeletal medicine.

The Problem of Pain and Diagnosis

Trigger points are traditionally linked to fibromyalgia, a poorly understood disorder with no solid diagnostic tests. It’s possible that this kind of chronic pain is the result of a quirky nervous system that deals with pain signals differently. Since it often coexists with depression, it’s critical that effective therapies be found. This can only be done if your physicians take a broader look at your symptoms and all their potential causes.

Trigger point therapy stretches out the trigger points to relieve pain, either with physical manipulation or injections. Call it a combination of massage therapy and physiotherapy if you will, because these modes of care come with plenty of evidence. Chronic, non-malignant pain usually responds well to massage, and injections are even more powerful.

Myofascial pain syndrome is said to describe chronic, aching, generalized pain—a description that could be used to describe arthritis, early M.S., repetitive strain, and any number of other disorders. Trigger points are thus not adequate diagnostic or treatment tools on their own. Your doctor will use them to identify referred pain patterns after other conditions have been thoroughly tested for. Pain Stop Clinics will comb through your symptoms and ensure you receive the most efficient treatment for your unique problem.

This is Your Brain on Pain

Chronic pain is more than a frustration or a nuisance, it can truly impact every aspect of your life. It reduces your quality of life.

Pain can be challenging to treat. Medications work in the short-term. However, due to the risks of pain medication, many doctors and scientists are researching and endorsing other methods of pain management. This research has led to numerous studies on how pain impacts your brain.

Pain and The Thalamus

The thalamus is the connection between the spine and the higher areas of the brain. Any time you sustain an injury or feel pain, the thalamus creates a passageway through which the “pain message” is transmitted. Once pain subsides and an injury is healed this passageway essentially closes. However, some research now indicates that for those who suffer from chronic pain this passageway remains open.

Pain and The Prefrontal Cortex

The prefrontal cortex is the control center for our emotions and dictates much of our personality and behavior. Studies have indicated that there is a link between chronic pain and a decrease in the volume of the prefrontal cortex.

Perception and Pain

Pain can also affect your perception. If you suffer from chronic pain you may have trouble pinpointing the location of exactly what hurts. You may also notice changes in how you perceive touch. Research indicates that this may be due to a change in how cells communicate with each other.

The good news is that these impacts can be reversed. Pain causes change, not permanent damage. Effective pain management is the key to reversing this impact and improving your quality of life. Contact Pain Stop Clinics today to help find the best solutions and techniques to manage your pain.

 

How to Cope with Painful Episodes

If you experience chronic pain, you know your pain levels fluctuate. Sometimes it’s tolerable, and sometimes it takes over entirely. Some people can predict episodes based on their triggers, while for others the pain strikes unexpectedly. Managing these painful episodes greatly improves your quality of life. Here are some methods you can use that don’t involve medication:

Biofeedback

The more tension your body carries, the worse pain will be. Professionals use machines to release muscle tension and slow down the heart rate. These machines train the body to relax at will. Once the technique is mastered, the patient can learn to relax without the help of machines.

Distraction Methods

There’s nothing wrong with a little distraction when it reduces the intensity of your pain. Patients are encouraged to listen to music, talk to friends or read a book as a positive distraction. You can also concentrate on pleasant mental pictures and memories.

Relaxation Training

This is another method of releasing muscle tension with the help of slow, deep breathing and thinking calming thoughts. Relaxation tapes are made available to patients which guide them through the process of achieving a more tranquil state of mind.

Pain Transfer or Transform

With practice, these techniques can be highly effective. Pain sends a signal to your brain, and this is essentially your brain sending a signal back that says “yes, message received, but no thank you.” You can concentrate on an area of your body that isn’t hurting, for instance, or send your aching neck on a river cruise while the rest of you goes about your day.

Hypnosis

This technique is used to reduce the patient’s awareness of pain. Hypnosis is carried out by a professional therapist, who plants a post-hypnotic suggestion to reduce the sensation of pain. In some cases, patients can also learn to hypnotize themselves.

Remember, painkillers may provide quick relief from chronic pain, but they carry many risks. If you’re ready to take control of your life by controlling your pain, visit one of our pain professionals for a free consultation.

 

Benefits of Warm Baths

Many people suffer from musculoskeletal conditions such as low back pain, arthritis, and fibromyalgia. If you have been suffering from painful conditions, consider perhaps the oldest form of alternative therapy: soaking in warm water. Here are some of the benefits of this ancient technique, explained in modern language:

Enhances circulation

Heat improves blood circulation around aching muscles and joints. Blood delivers oxygen and nutrients that promote healing. When you experience pain, drink a glass of water to help increase blood flow.

Eases the stiffness

Warm water treatment helps relax the tendons that make the muscles and joints feel stiff, reducing pain and improving your range of motion.

Reduces compression

When you submerge yourself in water, you relieve pressure on your joints. Move the aching muscles and joints to stimulate blood flow and enable the joint loosen up.

For best results, soak in the warm water for at least 20 minutes. Make sure it’s warm, too, not lobster boil hot. Your nerves are likely to respond to unwanted heat levels with a pain response, so keep it comfortably warm. Of course, if you recently injured yourself and are experiencing painful swelling, you should probably hold off on any kind of heat treatment until the inflammation goes down.

Heat or Ice for Sore Muscles?

When treating muscle pain, should you opt for cold or hot therapy? This tends to confuse people who have had different results with different methods of pain relief. Some think it’s better to go for hot, while others think it’s better to go for cold.

For muscle pain caused by an injury, it’s best to choose both, with cold coming first followed by hot. For chronic muscle pain, heat is usually best.

Cryotherapy

Cryotherapy is a form of pain treatment that exposes irritated nerves to freezing temperatures for a few minutes. The cold reduce blood flow and deadens the nerves, resulting in decreased inflammation and consequently, pain. Cryotherapy can be localized or general, though it’s more often used to treat localized nerves. Generally it’s advisable to treat muscle injuries with ice intermittently for up to 48 hours after the injury.

Thermotherapy

Thermotherapy is a form of pain treatment that uses heat to alleviate pain. The heat dilates blood vessels, causing tight muscles to relax and removing waste buildup of lactic acid. It also increases the oxygen delivered to the targeted muscles, facilitating faster repair of damaged tissue.

Both cryotherapy and thermotherapy can be simulated with a cold and hot compress, respectively. This DIY approach works for mild pain. Your pain management professional may recommend using one or both of these therapies at home.

For serious and chronic pain, these therapies may only provide temporary or supplemental relief. At Pain Stop Clinics, we take a holistic approach to treating pain disorders. Your treatment plan will be tailored to your diagnosis and individual needs. Heat and cold treatments are one simple, proven method that can be used in conjunction with several healing modalities.

7 Bad Back Habits to Avoid

Back pain may result from a recent or past injury. It can develop gradually over time from repetitive motion, or from lack thereof. While seeking out assistance in diagnosing and treating your back can help clear up the problem, you can help yourself by avoiding these seven bad habits that cause back pain.

Not Exercising

Exercise prevents injury throughout your body by strengthening the muscles. Yoga, pilates and other core workouts strengthen the back and ease strain by also strengthening the abdominal muscles.

Poor Posture

Bad posture causes muscle strain and increases the level of stress on your spine. To improve posture, keep your shoulders back (to avoid slouching), sit against the back of your chair, and stand with a slight bend in your knees.

Improper Lifting

When lifting heavy items, bend your knees and use your leg strength to reduce strain on your back. Make sure you don’t curve your back over the object you’re lifting.

Baggage

As Erykah Badu soulfully reminds us, “Bag lady/ You gon’ hurt your back.” Remember that bags, briefcases and purses count as lifting. If you regularly carry a lot of stuff, consider a wheeled briefcase, a properly adjusted backpack or a downsized purse.

Smoking

There isn’t much good that comes out of smoking, and you can add back pain to your list of reasons to quit. Smoking cuts down blood flow to your disks, increasing back pain.

Calcium and Vitamin D Deficiency

These nutrients develop and strengthen your bones. Discuss increasing your daily intake with your doctor, because there is such a thing as too much of a good thing. Too much calcium, for example, could result in kidney stones, which entirely defeats the purpose of reducing back pain.

Weight

The more weight you carry, the more your muscles and joints strain to support you. Of course, pain makes exercise more challenging. Set realistic exercise goals, eat a balanced diet, and discuss any issues you are having with your physician or professional.

Not Moving

If your back hurts, you might want to settle into the couch, but unless you have a serious injury, rest may be counterproductive. Stretch out and get the blood flowing instead.

Back pain can make everyday tasks difficult to perform. Although there may be deeper causes or complicated symptoms, improving your habits can reduce pain and improve your quality of life.

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