How to Tap into Your Brain to Manage Your Chronic Pain

Guided imagery, hypnosis (no, not the kind where sensible adults oink like barnyard pigs on a stage), distraction, and music are all legit—research-backed—ways to relieve chronic pain. If you've never considered these treatments, here's what you need to know. 

If you live with chronic pain, you've probably been told more than once that your [insert symptom here] is “all in your head”. It's infuriating but chornic pain is often invisible and for many people seeing is believing. The connection between the body and the brain—known to physicians as mind-body medicine—is gaining acceptance among experts as a way to manage chronic pain. (Chronic pain is defined as pain lasting more than three months.)

Mind-body therapies (hypnotherapy, guided imagery, etc.) focus on the sensation of pain, rather than the pain itself. Psychologically-based, these techniques help modify the emotional and cognitive meaning of pain.1 But you don’t need to be a psychologist—or even work with one (in some cases)—to practice these therapies. Many of them can be learned, using apps or from trained therapists, and practiced at home!  Below are therapies to help you tap into your mind-body connection and change your perception of the pain you feel.  

Guided Imagery 

Guided imagery involves using your imagination to create images that decrease pain. This technique often involves several or all the senses: vision, smell, sounds, touch, and taste. Your mind will travel to a beach, forest, or other pleasant place allowing you to experience sensations beyond your pain.  It can be used to help relieve: 

  • Musculoskeletal pain—pain involving the bones or muscles 2
  • Pain from arthritisi and other rheumatics diseases 3

You can try guided imagery at home with the aid of an audiotaped script or popular apps like Calm, Headspace, or Insight Timer.  Research has shown that guided imagery can help to relieve pain from rheumatic diseases, such as rheumatoid arthritis and osteoarthritis, as well as improved anxiety, mobility, and quality of life.

People with fibromyalgia experienced no effect on pain with guided imagery, but did experience potential positive effects on psychological distress and coping with pain.4

Hypnosis/Auto-Suggestion 

Despite its association with swinging pocket watches and two-tone spinning wheels that lure innocent victims into a "trance," hypnosis is a well-studied treatment modality that involves learning how to use the mind and thoughts to manage emotional distress, certain habits or behaviors, and unpleasant physical symptoms—including pain. Self-hypnosis is even possible. Hypnosis can help relieve:

  • Headache
  • Backache
  • Dental Pain
  • Fibromyalgia
  • Cancer-related Pain
  • Tempomandibular Disorder Pain
  • Pain from Multiple Sclerosis
  • Mixed Chronic Pain 

Hypnosis involves learning how to use the mind and thoughts to manage emotional distress, certain habits or behaviors, and unpleasant physical symptoms – such as pain. And you don’t have to lie on a couch listening to therapist to reap its benefits. Apps such as Clementine and  Mindset  teach the basics of self-hypnosis and their users claim the apps have been helped them quit smoking, feel less pain during childbirth, and sleep better, too. 

Hypnosis has been found to be generally more effective than non-pharmacological treatments, such as physical therapy and pain education, for a range of pain conditions, including dental pain, low back pain, post-operative pain, and multiple sclerosis.6,7,8,9 There is growing evidence to suggest that the practice of hypnosis may have a greater influence on the effects of pain rather than the sensation of pain.10,11 

 Hypnosis may also be able to reduce stress, relieve anxiety, improve sleep, improve mood, and/or reduce the need for opioids.  You can train yourself in self-hypnosis and auto-suggestion. The hypnotic session involves using soothing, repetitive, fixed and generally-positive phrases for about 10 to 20 minutes.  

For example, you might say to yourself, “I am becoming calm and relaxed. My back is beginning to feel wonderful.”  For more on hypnotherapy read, Hypnosis and Biofeedback. (Note, this article, geared to clinicians appears on PPM's pro side.) Research findings suggest that this type of hypnosis may potentially provide symptom relief and improve overall gastrointestinal functioning in patients with irritable bowel syndrome.12  Further, hypnosis may enhance the effectiveness of other well-established psychological treatments for pain.7    illustration of drummerStudies show drumming can be an effective form of pain distraction as well as promoting the production of feel-good endorphins—the body's natural opiates.

Relaxation  

The goal of relaxation techniques is to encourage the natural relaxation response in your body by slowing breathing, lowering blood pressure, and producing a feeling of increased well-being, according to the National Center for Complementary and Integrative Health.2 Relaxation therapy can help with the following pain conditions and pain-related symptoms.2

  • Tempomandibular Joint Dysfunction (TJD)
  • Chronic headaches and other types of chronic pain in children and adolscents
  • Anxiety association with illnesses or medical procedures (Note: relaxation is not recommended for generalized anxiety disorder which is best managed with the guidance of a trained mental health professional)
  • Insomnia

Here are a few relaxaion techniques you can try at home: 

  • Diaphragmatic breathing (think deep breathing) is breathing into the lungs by flexing the diaphragm rather than breathing shallowly by flexing the rib cage 
  •  
  • Progressive muscle relaxation (PMR) involves tensing and relaxing of different muscle groups of the body, while focusing on the difference between the feelings of tension and relaxation.13  
  •  
  • Autogenic training is a technique that uses visual imagery and body awareness to help you focus on your breathing, muscle relaxation, and heartbeat, It reduces anxiety as it relaxes and calms your body. 
  •  

Recent research indicates that relaxation can even be used to reduce acute pain, such as that from a bone fracture or surgery, too.14  For more information about step-by-step relaxation techniques read our guide, How to Use Relaxation Techniques to Prevent Pain Flares.

Distraction / Displacement of Attention 

Distraction therapy is exactly what it sounds like – it involves a process of diverting your attention from your pain. Like the nurse who helps calm a child while giving him an immunization by getting him to talk about his favorite toy. This same technique  can work in certain cases for adults and for longer painful episode, too. 

Activities such as gaming, blowing bubbles, doing a puzzle, making a craft, reading, writing, or drawing can all distract from pain. Be sure to choose something that really interests you in order to keep you fully engaged —and distracted. It's best to have a few activities in mind because the awareness of pain may return when you stop the activity. 

Research has found that activities with potential to become more stimulating when the pain increases are most beneficial.15 For example, beating a drum at different intensities based on your pain level. This will likely take some experimenting because like medication, not every type of therapy works for across the board for every person. One type of distraction that has shown success for chronic pain is virtual reality (VR)

Recent studies have shown that VR programs are most effective when the person is fully immersed in the virtual environment.16 One study, led by pain researcher Beth Darnall, PhD, at Stanford University, found a more significant reduction in pain in patients with low-back pain or fibromyalgia who used a VR program that included cognitive behavioral therapy, relaxation, and mindfulness compared to using an audio-only VR program.17

Music Therapy 

Music therapy is most often used in hospitals and cancer centers, and is accepted as a discipline alongside other professions such as physiotherapy, occupational therapy, speech therapy, psychology, and education services.18 In pain management, research has shown how listening to music can relieve a variety of pain conditions. It's not necessary to be pitch perfect to reap the benefits of music therapy. Listening to or performing music—singing in the shower, playing an instrument for fun, or beating a drum (or the tabletop!) for the heck of it, can be therapeitic, too. 

Drumming, it turns out, just may be the ultimate distractor. Research suggests that as drumming distracts from pain, it promotes the production of endorphins and natural opiates. Other studies have shown that music may increase the effectiveness of medical therapies and may be used in conjunction with other pain-management programs.19 (For more on music therapy for fibromyalgia.) 

Other Therapies You Can Try at Home 

Therapies such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness also can be a great help for managing your pain and pain-related anxiety and depression. You can learn these techniques through sessions with a pain psychologist or therapist and practice the techniques at home. Ask your primary care physician, rheumatologist, or other specialist to refer you to a therapist.  In the meantime, learning what others do to cope with their pain can also be extremely helpful. Consider joining a support group − in person or virtually. For more information you can also check out the resources list on our Community Advice page. 

Updated on: 10/02/20
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