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Pain Management: What do you do?   

Pain management: How do you cope?  

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Pain Management: How do you cope? 

Pain management and pain thresholds 

It is a well-known fact among those working in pain management that sensitivity to pain actually differs from individual to individual and from culture to culture. Pain management research has also found that it is possible to test your pain threshold by holding your hand in freezing water and measuring how long it takes before it hurts, and then when it actually becomes unbearable.  Most people cannot do this for more than a couple of minutes.  Some of these experiments have found that men may have higher pain thresholds then women, although some of these studies may be inconclusive, and may have trouble in determining whether these differences are actually more socially determined.  Men are sometimes conditioned to appear brave under such circumstances.  Also, some studies have found differences between cultures.  Studies have shown that Mediterranean people for example, sometimes report pain in response to stimuli that northern Europeans described as merely unpleasant.  These various findings may indicate that there are biological differences, but also that different cultures either repress or emphasize the expression of pain.  These cultural and individual differences may have important implications in the development of effective pain management programs. 

 

Pain Management and effectively dealing with pain: 

There are techniques including meditation, relaxation, hypnosis and behavioral modification that can reduce an individualís experience of pain by focusing their attention on other things.  The effect of attention on pain management has been demonstrated in various studies including a study in which patients were hypnotized before being operated on without anesthesia.  Under hypnosis, they were told that they would not experience pain and that the pain would be felt by a "hidden observer".  Most of these patients reported feeling no pain after surgery.  When the hypnotist then addressed the "observer", the observer reported excruciating pain. These findings suggest that even though we may feel the sensation of pain, in some conditions we can probably disassociate from it, which may actually affect the way that it is actually registered by the brain. 

Conversely, fear and anticipation are believed to actually worsen the sensation of pain.  If  an individual has experienced severe pain in a specific experience in the past, it is believed that the anticipation (or expectation) of pain may create the expectation (and the actual experiencing of pain) of suffering in the same way again.  The person will probably attend more closely to their feelings when they are experiencing this specific situation, and the attention make the new experience even more painful. In situations like these, psychotherapy may be helpful to uncover the related unconscious expectations and give the person the ability to divert their attention from pain stimuli in future situations. 

Refocusing attention away from the pain stimuli is a pain management technique used by practitioners of yoga, where they have been found to do such amazing feats of endurance and pain management as lying on a bed of nails or walking barefoot across red-hot coals.  They have been found to be able to "retrain" their thinking through meditation and have managed to reduce the significance of pain signals to their brain in a way that they are then able to not experience pain in the same way as most ordinary individuals. 

Pain Management through the use of pain medication: 

Pain management may also be effectively handled medically in both the short and long-term, in addition to understanding the role of expectations, mental state and psychological makeup. There are now a full array of pain killing medications available which are frequently found to be very beneficial. These medications are believed to actually interfere with pathways of pain to conscious attention or may actually act at the site of  the pain.  The most suitable analgesics depend on the nature and cause of the pain, and also whether pain is severe and persistent.  A doctor's advice and a medical evaluation is always necessary for the initiation of effective pain management.

Some information from Making the Most of Your Brain

Paul Susic Ph.D. Licensed Psychologist (Health Psychology)

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