Ouch! What a Pain | Jackson Free Press | Jackson, MS

Ouch! What a Pain

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Pain might begin in your body, but your brain has the power to exacerbate or even alleviate it.

Last year, pain radiated from James Lynch's neck down his right arm. A professor and interim chief of neurobiology and anatomical sciences at the University of Mississippi Medical Center, he knew from years of research and teaching where his pain was coming from and which nerves were being pinched. But he was still victim to his pain.

"I could hardly pay attention when a person was talking to me," he says. It was once so bad while teaching a lecture, he had to stop using his arm and rest it on the podium to continue. Lynch tried traditional pain medicines like Ibuprofen and found no relief. The only thing that helped him was using a heating pad.

We have all had some form of pain in our lives. Back and spinal problems are the second highest-ranking disability for Americans, runner-up only to arthritic pain, the Centers for Disease Control in Atlanta reports. These are only two of many pains that we face—migraines, tension headaches, sickle cell pain crises, menstrual pain, post-surgical pain, sports injuries—and the list goes on.

Pain isn't isolated only to a stimulus or injury site. Our emotions and environment play a role in how we perceive pain. In other words, our brains can intensify or alleviate pain. A child falls to the ground, sees his mother's anxiety and fears that he has hurt himself. The fear has him crying louder than if he had been left alone. I stub my toe and experience pain for the next three hours, but a marathon runner loses a toenail at mile 15 of 26 and barely notices.

Because pain can be such a disabling part of life, much research and funding has gone into finding evidence-based ways of dealing with it. Gus Sison, a clinical psychologist on the Mississippi gulf coast, has focused much of his career on helping patients with chronic pain.

"Pain begins with an initial physical insult to the body, but we know that pain is exacerbated by psychological (factors)," he says, "Pain is complex. ... People suffer different ways with the same physical ailment."

A shrimper with back problems who has lost his job as a result will experience his pain much differently than a computer programmer who is still able to function and earn a living, for example. The shrimper may be more prone to depression because of his inability to provide for his family, making his pain more debilitating.

Pain in the Brain
There are many nerves that relay pain and sensation from the body to the brain, and just as many nerves controlling reactions from the brain to the body. When you touch a hot stove, nerves send a painful stimulus telling your brain about the pain. The brain then sends a stimulus to your hand to make your muscles tense and jerk your hand away.

"In addition to the sensory pathways going into the brain, sensory systems have pathways coming from the brain that terminate in the sensory pathway's relay centers, which can modulate the incoming sensory signals, in this case, the pain," James Lynch says.

The brain can potentially override pain messages with psychological or physical sensations, choosing which impulses it allows in and working as a gatekeeper. For example, when you get relief from a heating pad on your hurting back, an overwhelming sensation of heat downplays the sensation of pain.

This is a simplified version of clinical psychologist Dr. Ron Melzack and neuroscientist Dr. Patrick Wall's gate-control theory pioneered in 1965. This theory helps to explain how our other senses can affect a sensation of physical pain. The brain can prioritize which sensation to focus on. Some of the alternative therapies available for pain management capitalize on this theory by redirecting your brain to feel pain differently. Read "Train Your Brain" on the right to find out more.

Train Your Brain
With acute pain from an injury or a headache, taking aspirin or Tylenol may be all you need. But for chronic pain that has extended beyond the point of normal healing, over-the-counter medicines may not provide relief. They can stop working, or their side effects become a larger issue than the pain.

You can train your brain to divert your attention away from your pain. Pain can respond to behavioral modifications such as developing coping mechanisms, learning deep relaxation or meditation and hypnosis. With diversionary techniques, the pain may still be there, but your mind is no longer focused on it.

Physical techniques to help with pain management include acupuncture, massage therapy and transcutaneous electrical nerve stimulation (TENS).

People vary in their responsiveness to any therapy, and no technique is guaranteed to bring instant relief. Begin by knowing that you can ask for help and learning whom to ask for guidance.

Always talk to your doctor if you have pain and want to try a new technique. Because pain varies from person to person, what works for one may not be the answer for another. Talking to your physician is a great first step.

Source: WebMD: Alternative Treatments for Pain Management (http://www.webmd.com)

Basics of OTC Pain Meds
When you're looking for pain relief, the choices at the drugstore can overwhelm you. What's more, they aren't all created to treat the same thing. Here's a quick guide to common over-the-counter pain medications. Remember: More is not better. Always read and follow exactly the directions and dosages on individual medications. Talk to your doctor or pharmacist for more information, contra-indications and how your prescription medicines will interact with other pain medications. Always tell your doctor about any OTC drugs you take.

• Aspirin (Bayer, Bufferin, Ecotrin) works for pain, fever and to reduce inflammation. Don't take if you have an ulcer or kidney disease.

• Acetaminophen (Tylenol) works for pain and fever. Don't take this with alcohol or if you have liver impairment.

• Ibuprofen (Motrin, Advil) works for pain, fever and inflammation. This also helps with arthritic pain. Don't take Ibuprofen if you have ulcers or kidney disease, or if you have high blood pressure; ibuprofen can raise blood pressure.

• Naproxen (Naprosyn, Aleve) has the same properties as Ibuprofen, but it lasts longer so you take it less often.

• Combination products such as Excedrin (Aspirin+Acetaminophen+Caffeine) have the same properties and worries as individual drugs. Caffeine can provide extra relief from headaches.

*When treating an injury, headache or arthritis, it's important to stay ahead of the pain by taking medicine as recommended. If the package recommends taking a dose every four to six hours, keep up with that dosage to prevent your pain from bouncing back worse than before.
Source: u.s. National LIBRARY OF MEDICINE Pubmed health website (http://ncbi.nlm.nih.gov/pubmedhealth)

Internet Resources
• American Chronic Pain Association (http://www.theacpa.org)
• WebMD: Alternative Treatments for Pain Management (http://www.webmd.com)
• National Institutes of Health, National Center for Complementary and Alternative Medicine (http://nccam.nih.gov)

Alternative Pain Therapies
• Behavioral Modification or Therapy
• Hypnosis, Relaxation, Meditation
• Diversionary Techniques
• Yoga
• Acupuncture

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