Pain relief strategies: Your beliefs may worsen it!


What happens when you accidentally cut your finger with a knife or accidentally expose your hand to fire? Your nervous system receives a stimulus of pain and signals you to drop the knife. Pain is an indication that something is wrong and needs to be corrected. The neurons conduct pain from the site of stimulation to the brain. The brain processes the information and instructs you to stop what you are doing. Since the brain and nerve cells are the centers of pain processing, they are also the basis for pain relief. Consequently, your emotional, psychological, and thought process influence your pain experience.

How does pain work?

Nociception is the process by which the system carries information from the site of stimulation to the brain. Nociceptin receptors aid in this process and are not similar to the receptors of touch, taste, and smell. They are present in the peripheral system and thus carry the stimulus via the peripheral nervous system, which decides the urgency of response. 

The C-fibres carry dull and slow pain, usually observed in chronic conditions. A-delta receptors are larger than C-fibres and hence can transfer the stimulus quicker, resulting in sharp and throbbing pain. This pathway explains why you feel a prickling pain when you cut your finger, which gradually progresses to dull and lasting pain. 

How do painkillers work for pain relief?

Though the system releases natural pain-relieving chemicals– endorphins and enkephalins, you may sometimes need assistance with external pain-relieving factors. The painkillers you take do not reach your head or shin to relieve pain.

Instead, it interacts with the nerve endings, stopping the pain stimulus from reaching the brain. In the event of cell injury, they release pain-causing chemicals. The nerve endings pick up the response and send it to the brain. 

A painkiller like ibuprofen or aspirin dissolves throughout the body and prevents the cells from releasing these pain-causing chemicals. As a result, the brain receives unclear or no pain signals, keeping you away from pain.

Painkillers also work by interrupting the pathway of pain signaling, rather than working at the site of stimulation. 

Since the nerve cells cannot transmit the message clearly, it won’t reach the brain, acting as a pain relief treatment. However, different painkillers have different therapeutic activities.

The gate theory of pain 

According to the gate control theory, the pain passes through the peripheral nervous system to reach the central nervous system. The CNS modulates the signals by a gating mechanism and sends it to the brain, which processes them. Hence, if you can influence this gating mechanism, you can also influence pain perception. The mechanism prefers non-painful inputs over painful ones.

You can mess with this system in two ways– when you rub your hand after banging it to a wall, you overload the mind with multiple signals from the same regions. In these events, the gate prefers sending the senses of vibration and pressure over pain to the brain. Thus, you successfully override the pain perception pathway, relieving yourself from the sharp pain.

Also, you may tie a compression bandage around the site of injury to apply constant pressure, which prevents the fluids from gathering at the specific region. The second way is your psychological, emotional, and cognitive response to pain.

Cognitive and emotional brain influence pain relief treatment

People often prefer medical care for pain, but mostly subjective perception determines the need for medical attention. The brain reacts to various stimuli at once. It decides what gets more attention and what needs to be avoided concerning environmental conditions.

Depending on your need for survival, the stimulus will elicit a response of approach or avoidance, concerning the resulting emotional state and consequences. Since pain is essential for well-being, it will involuntarily attract attention. 

Yet, if your focus is on pain, it seems more intense, and when you distract from the pain, it seems less severe. However, if your complete focus and attention is on pain, i.e., attention hypervigilance for pain observed in chronic conditions, even moderate pressure can seem unpleasantly intense.

You decide what pain feels like

Your brain undergoes a process of thought to determine the potential harm caused by the pain. The evaluation depends on you and varies from one person to another. Pain intensity and sensation form the basis of this evaluation. Alterations in the somatosensory cortex determine the pain intensity, whereas modifications in anterior cingulate cortex determine the unpleasantness. You may feel like the muscle pain in your lower back is intensifying though it is constant in reality. 

For example– marathon runners have intense pain in their leg muscles. They perceive the “burning sensation” as a pleasure and a sign of increasing strength. But, you in the audience may feel the need for immediate attention for potential damage. 

If your brain is focused on a specific task, it dampens other signals that are not related.

Furthermore, if you believe the pain is controllable and you can cope with it, it seems less threatening. Moreover, during this process of evaluation, if the resources do not seem sufficient, you may feel the pain intensifying. The intensity reduces depending on how you control pain rather than the pain controlling you. Ventrolateral prefrontal cortex activation is a sign that you have the upper hand over.

Meanwhile, reinterpreting your pain as innocuous stimuli works as a pain relief strategy. Contrastingly, viewing it as an uncontrollable and overwhelming stimulus can increase unpleasantness.

Your negative emotions act against pain relief.

Pain can elicit a robust emotional response. It may result in anger or sadness depending on how you perceive it– for instance, “It’s not fair that I have to live with this pain all my life” expresses anger, whereas “My life is hopeless with this persistent pain” expresses sadness. Fear is also a typical response depending on the threat level. These reactions influence endocrine and immune responses.

Furthermore, pain inputs from essential internal cavities may lead to hypotension and fewer reactions to the environment– a sign of a depressed state. Additionally, pro-inflammatory cytokines are released during negative emotions, enhancing pain perception. When the release is persistent and chronic, it may lead to tissue damage.

Pain elevates the activity of the sympathetic nervous system, increasing anxiety, and heart rate. Increased amygdala activity in events of stress and anxiety divert attention towards pain, increasing intensity, and unpleasantness. 

Negative emotions like fear and anger release norepinephrine which can dampen the pain signals temporarily; but on a prolonged level it can increase blood flow to the site of stimulation causing painful spasms, aggravating the original injury.

These emotions can also increase the neural threat processing and will most likely perceive the stimulus as pain. Thus, fear increases pain hypervigilance. Additionally, these emotions alter prefrontal cortex activity, reducing the ability to regulate pain. 

What are other pain relief strategies?

Conclusively, pain can gradually damage your health and well-being. Your mental health can influence the pain experience. If you are weak psychologically, it is challenging to come out of this trap and vicious cycle of physical fitness to mental health to physical health decline.

Since your psychology can influence pain perception, it is vital to practice activities than increase your health psychologically as well. In the events of uncontrollable pain, consult your therapist for pain-relieving treatments and medications. Never lose hope!

Related: How music influences your thoughts and perception?

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